Misconceptions in Palliative Care
Background of study
There are many patients who suffer from end-stage renal diseases (ESRD) especially in late stages of their lives. This fact has sparked a heated debate on the kind of care that should be accorded such patients in terms of treatment bearing in mind that these patients have shortened life spans and also confront many health care challenges. According to McGrath and Goodlin (2017) close to 40 illion individuals are in need of palliative care annually. However, the paltry 14% of these people have access to the palliative care since a majority of the people reside in low or middle countries. Various factors can be attributed to the little coverage of palliative care. Some of the other factors are the low level of awareness and the many misconceptions that dog palliative care.
Method of study
This research paper seeks to address Palliative care and misconceptions that limit access for patients with ESRD. The author of this paper uses a qualitative as well as an empirical method of research. The author utilizes several resources from experts in the field who have conducted research in palliative care in the recent past. The main resource is Jablonski’s article on “Palliative Care: Misconceptions That limit Access for Patients with Chronic Renal Disease” (2007). In definition, Palliative care infers to the approach that is meant to improve the quality of life for individuals with a terminal illness such as Cancer. However, since Chronic Renal Disease is just as serious, there are many professionals in the field who feel that the same kind of care should be extended to patients suffering from ESRD. The primary role of palliative care is to accord people suffering from life threatening illness with an atmosphere where they can receive physical, spiritual and social assistance.
Results of the study
According to Jablonski’s article, whereas this kind of care is meant to ease the health care situations of individuals approaching the last stages of their lives, there are numerous misconceptions that surround this practice. These numerous misconceptions pose significant challenges as it is difficult to convince people that it is the right approach for such patients.
According to Jablonski’s article on “Palliative Care: Misconceptions That limit Access for Patients with Chronic Renal Disease” (2007), she argues that people are not aware of what palliative care really entails. Lack of awareness poses a significant challenge to health providers since advantages attributed to palliative care are not fully being utilized by patients who need it. For instance, she argues that many people think that Palliative care equals hospice care. This is a misconception that has dogged palliative care, yet there is a very clear distinction between the two. Hospice care is the care that is provided to the individuals on the verge of death. Therefore, many people often think that all persons who require palliative care are on the dying. In reality, all hospice care is palliative care, but that does not equate that all palliative care is hospice care. In as far that palliative care and hospice care require a multidisciplinary team of nurses, doctors, dieticians, and social workers, the primary objective is improving the quality of life by relieving suffering. therefore, an important service provided to all individuals, but it does not mean that such individuals are dying. As a matter of fact, this point is related to another misconception identified by the author.
Jablonski argues that people also think that Palliative care is best offered through hospice organization because of their well-established infrastructure. She dismisses this misconception due to the fact that patients who may not have imminently terminal conditions are sometimes unable to access their care. In truth, the essence of palliative care is to ensure that individuals have access to the choices that will improve the value of the life of both the patients and their families. One of the groups of individuals who may need palliative care but still require active treatment are those with end stage renal disease (Jablonski, 2007). The fact is that the palliative care is meant to improve the quality of life of patients from the time of diagnosis of the life limiting disease to the death with disregard to the active interventions. This misconception has led to the low level of access to palliative care among many people. In reality, palliative care is not primarily confined at the hospital set up. It is easy to set up a palliative care based on the patient needs; those patients who may not necessarily be in need of specific equipment that is only found in the hospital set up may receive palliative care at home. Therefore, it is wrong to equate palliative care to the hospital set up. Palliative care can be provided can be provided wherever the patient resides. These can be at the hospital, hospice, long-term care facility or even at the patient’s home. Therefore, it essential that to have the misconception cleared since it prevents many from seeking palliative care.
The other misconception that Jablonski identified is the fact that many people think palliative care hastens death. Many families often think that once they’re next of kin has been told that they require palliative care, they on the verge of death and soon or later they will die. Many also hold that palliative centers often hasten death since they have noticed that the death rate at the Palliative center is high. In reality, palliative care does in any way hasten death. The truth is that it assists in improving the quality of life for the individuals with terminal illnesses until the end of life. The patient is often accorded spiritual, physical and social assistance at the Palliative centers.
There is also a misconception that a chronic illness alone does not qualify a patient for palliative care. Jablonski wishes to expound on this notion since the World Health Organization(WHO) specifies that palliative care should be provided to patients whose illness is not responsive to curative treatment. ESRD fits squarely in this bracket as its symptoms seem to persist posing a significant challenge to the curative treatment approach. Furthermore, WHO categorically specifically points out that palliative treatment should not be limited to patients who are approaching the end of life, but to all individuals whose diseases are not responding to curative treatment.
The above point further explains the next misconception identified by Jablonski, which states that ESRD patients are not appropriate for palliative care since they receive active treatment in form of RRT. According to Jablonski (2007), the terminology “active” in providing care to ESRD treatment fails to provide a proper definition in regard to Medical Hospice Benefit in the US. This is much more so because the eligibility criteria imply that the outcome of “active treatment” is curing the disease in question. However, this is not the case for ESRD as the disease seems to persist even with active treatment in form of RRT.
Other than the misconceptions identified by Jablonski, there are also many authors who wish to clarify on many others that surround palliative care. For instance, there is a misconception that palliative cares the moment one hears of palliative care, one should know that physicians have given up on those patients (Senthil, 2015). Many people often think when doctors prescribe palliative care; there is nothing more they can do to save the patient. In truth, doctors often advocate for palliative care since they believe that the patient will benefit immeasurably. Palliative care often shifts the patients hope and attentions from cure to living life in the best way possible. It is essential to point out that palliative care also assists in improving the quality of life for patients with terminal illnesses by incorporating approaches that shift their attention from their afflictions to what will make them happy.
Ethical Considerations
From the observed misconceptions, it is evident that there are areas that need to be addressed before a physician recommends a patient for palliative care. For starters, a healthcare provider should consult with a patient’s family and advice on why a loved one needs palliative care. The fact that many people think that palliative care is only for terminal cancerous patients is proving enough that the health care has failed in its duty of educating people on the why patients need the practice. It is true that most of the individuals at the Palliative centers had been diagnosed with terminal stage of cancer. However, cancer is not the only illness that requires palliative care. It is imperative to mention that individuals who need palliative care may be in need of physical, emotional, social and spiritual assistance and is not primarily that they will have Cancer.
The fact that people also think that physicians’ neglects patients in palliative care also brings out an ethical issue, which may be the reason why patients with ESRD would reject the practice. It suggests that patients feel like they are being sentenced to early deaths when they hear of palliative care other than expecting to achieve improved quality of life. Palliative care is provided to the individuals from the time of diagnosis of any illness or disease that shortens life. The services provided in the Palliative care set up improve the quality of life.
Conclusion
From the above research, it is evident that there are many misconceptions surrounding palliative care. This research identified both the misconceptions and clarifications regarding who can benefit from palliative care, how it is provided, where it is provided as well as the definition by the World Health Organization. Jablonski (2007) calls for the urgent need to ensure that these misconceptions are cleared by raising more awareness. She feels that there is the need to promote public education on palliative care to eliminate the retrogressive misconceptions that have led to the low utilization of palliative care services, and I could not agree more.
References
Jablonski, A. (2007). Palliative Care: Misconceptions That limit Access for Patients with Chronic Renal DiseaseEthical Issues in Dialysis, 21(3), 206-209.
McGrath, L., &Goodlin, S. J. (2017). Palliative Care in Older Adults with Cardiovascular Disease: Addressing Misconceptions to Advance Care. Current Cardiovascular Risk Reports, 11(2).
Senthil P, K. (2015). Reporting of “Quality of life”: A systematic review and quantitative analysis of research publications in palliative care journals. Indian Journal Of Palliative Care, (18),59-67.
