APRIL 20 — Palliative care is a specialised medical care which aims to improve the quality of life of adults and children living with life-limiting illnesses, such as cancer, organ failure, certain degenerative neurological disease, and HIV/AIDS.
The palliative care approach addresses the physical (pain and symptoms), social, psychological, spiritual issues and other problems faced by the patient and their families.
Palliative care can be provided in the home, hospital, community clinic or nursing home by a team of qualified healthcare professionals.
Universal health coverage and sustainable development goals
Since the late 1960s, with the founding of the modern hospice movement by Cecily Saunders in the United Kingdom, interest in palliative care has been growing, together with encouraging signs of recognition by policymakers and influential bodies.
In December 2012, a resolution to progress towards Universal Health Coverage (UHC) was passed in the United Nations General Assembly(1).
The goal is to ensure that all people obtain the health services they need without suffering financial hardship. Within the framework of UHC, palliative care was recognised as an essential and needed health care service.
In May 2014, the WHO resolution to integrate hospice and palliative care into national health services was passed at the 67th World Health Assembly(2).
The resolution involves a set of standards and guidelines for palliative care, and the inclusion of palliative care in the health policies, budgets and healthcare education. Malaysia was a signatory to this resolution.
In September 2015, palliative care was recognised as an essential component of the Sustainable Development Goals (SDG) under the UN Agenda 2030(3).
With these in place, policymakers are tasked to make more resources available for the delivery of palliative care in their national health systems.
The scale of suffering
Worldwide, it is estimated that over 40 million people each year require palliative care(4).
Of the 20 million that require palliative care at the end of life, it is estimated that 18 million people do not receive it4.
Echoing these findings, in Malaysia, estimates from a recently published palliative care needs assessment revealed that every year more than 56,000 people require palliative care at the end of their lives, with less than 10 per cent receiving it5.
One of the key barriers to more people in need accessing palliative care services is the lack of awareness by the public. A public survey in 2016 revealed that over 90 per cent of Malaysians are unaware about palliative care(5).
By 2030, Malaysia will be an ageing nation where the proportion aged 60 and above will make up 14 per cent of the population(6).
In light of this, the urgency for palliative care to be delivered at some minimum standards, and as part of an integrated approach and a fundamental component of the continuum of care throughout the life course, is growing stronger.
Therefore, more support for public awareness initiatives to inform and educate the general public is important to drive the changes required at the national, community and provider levels.
As pain is one of the most common and distressing symptom that patients with a life-limiting illness will face, pain management is integral in palliative care.
Pain can be effectively controlled with the use of opioid medications, which are also the least expensive and simplest method of pain management.
Sadly, fears and myths of addiction, strict regulation, and inadequate training and understanding of the use of opioid medications among healthcare professionals, can limit access to oral morphine and other opioid preparations for pain management.
“Opiophobia” was coined to describe the unreasonable fear about the risks associated with opioids, which can arise in patients, family members, healthcare providers, and members of the public.
Palliative Care Awareness Month: April 2017
To draw attention to this issue, the global theme “Living & Dying in Pain, It Doesn’t Have to Happen”, set by the Worldwide Hospice Palliative Care Alliance (WHPCA) has been adopted by Hospis Malaysia for a month-long public awareness campaign throughout April 2017.
This campaign aims to reach more Malaysians through strategic partnerships and collaborations with other hospices and palliative care organisations, and the involvement of selected private businesses, medical centres and learning institutions within the Klang Valley.
An array of events, exhibitions, public talks, and fundraising activities have been planned for the month of April 2017, targeted at the general public.
Concurrently, ongoing engagement with healthcare professionals will take place through a series of continuous medical education and training activities.
For the list of events occurring in April 2017, please visit hospismalaysia.org.
1 United Nations. Draft Resolution (A/67/L.36) Global health and foreign policy, 6 Dec 2012.
2 WHO. 67th World Health Assembly: Resolutions & Decisions Annexes, 2014.
4 WHO. Global Atlas of Palliative Care at the End of Life, Jan 2014.
5 Hospis Malaysia. Palliative Care Needs Assessment 2016: Malaysia.
6 United Nations, Department of Economic and Social Affairs, Population Division (2015).
World Population Ageing 2015
** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail Online.