Palliative care

Treatments are aimed at complete healing.

The disease can no longer be completely cured, but it can still be stabilised or slowed down by a variety of treatments so that the patient may still have a longer life expectancy. Treatment consists, for example, of certain radiations, some forms of chemotherapy or hormone and/or immunotherapies, certain surgical procedures, haemodialysis, transfusions or artificial fluid and food administration, etc.

It often involves similar treatments as in a curative stage, but not with the aim of a complete cure, but rather to increase both life expectancy and quality of life as much as possible.

The disease can no longer be slowed down with treatments, but interventions and care are aimed at improving or maintaining functionality and comfort. Palliative care focuses mainly on comfort care with attention to the person as a whole. Palliative care accompanies people in different ways:

• at the physical level: controlling pain and other symptoms
• Psychologically: dealing with emotions
• Socially: paying attention to family, children and friends
• on a spiritual level: dealing with life questions and meaning, completing life

These aspects deserve attention even in earlier stages and are often supported by the entire care team: doctors, nurses, social workers, psychologists, pastors and volunteers, etc. Where necessary, the palliative support team can also provide support in this regard.

In practice, palliative care is, wrongly, often narrowed down to terminal care or bereavement counselling. However, palliative care is much broader and is best started as soon as the patient requires symptom control, even if palliative therapy is still being provided.

Palliative care can be offered in the hospital, in the home environment, in a residential and care centre, or in a palliative care unit (see also the patient brochure 'Care options in palliative care').

The disease is at an end stage, the actions are aimed at dying comfortably. The goal of care thus changes from comfortable living to comfortable dying. At this stage, it is necessary to critically consider all interventions, even more than usual, in advantages and disadvantages. Acts such as artificial fluid and food administration, antibiotic administration, etc. have often become useless and may even be harmful to the patient.

Stopping or not starting artificial fluid and food administration requires good communication with the patient and their relatives. Often, the patient's death is mistakenly seen as a consequence of stopping or not starting it rather than the consequence of the disease. At this stage, artificial fluid and food administration is no longer processed in the body, starts to accumulate (oedema formation) and sometimes causes a lot of inconvenience (e.g. swollen limbs and/or abdomen, shortness of breath, too much focus on technicality instead of human closeness, etc.).

This is the care that can be offered after the death of a loved one. The grief of bereaved families can be strongly determined by the way the deceased person received and experienced care. In certain circumstances, specialised grief counselling is needed.