Paradoxes in palliative care
Andrew Hoy
pp 80-80
Palliative care contains several paradoxes, real and imagined, some of which are reflected in this issue of the European Journal of Palliative Care. Palliative care has developed from the popular movement to relieve suffering; to find meaning in the last phase of life leading to death; and to return healthcare to an activity centred around the patient rather than the healthcare professional. The popularity and strength of the movement have been characterised by the intense interest and support from the public, and, alas, less so from the professionals.
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Symptom control during the last three days of life
Friedemann Nauck, Eberhard Klaschik and Christoph Ostgathe
pp 81-84
Even if they suffer from a progressive and incurable disease, many patients die ‘peacefully’. However, the terminal phase of an illness is highly dynamic and different symptoms may cause problems for these patients. During the last days of life, it is important to redefine goals, as previously present symptoms may increase and new symptoms may appear. Insufficient pain relief plus other symptoms make coping with illness and acceptance of progressing asthenia extremely difficult for the patient.
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Palliative plastic surgery
Graham Offer, Graeme Perks and Andrew Wilcock
pp 85-87
The treatment of cutaneous cancer deposits, especially those that fungate, is a challenging area in palliative care. Treatment with radiotherapy, chemotherapy and dressings is often unsatisfactory. The continuing tumour growth can worsen symptoms (for example, pain, malodour and haemorrhage), alter the patient’s body image and isolate them socially, impacting upon their quality of life. The pain from cutaneous metastases can sometimes be difficult to control with medical treatment alone.
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Competency assessment in palliative nursing
Robert Becker
pp 88-91
The search for a reliable and valid method of assessing nursing skills in practice has been likened to the quest for the Holy Grail. Many paths have been trodden, each with its own merits and drawbacks, making objective assessment at best, complex, and at worst, impossible. This article looks at the development of a working tool designed to help practising nurses assess the range of skills necessary for the delivery of palliative nursing. The tool is also designed to be a means by which the individual nurse can obtain a baseline assessment of their skill development and help them identify deficits.
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Research training and palliative medicine
Vincent Crosby and Andrew Wilcock
pp 92-94
Research is increasingly seen as necessary to help improve the quality of palliative care for patients and their families, and is an activity that specialist palliative care services are expected to undertake. Ideally, this requires consultants in palliative medicine to have been exposed to research training during their specialist registrar training programmes. Twycross and Dunn recommended that there be greater opportunities for trainees in palliative medicine to spend one to two years in research.
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The contribution of physiotherapy to palliative care
Diane Robinson
pp 95-98
‘Not dying from it but living with it’ – thus reads the title of the lead article in the June 1999 Newsletter of St Catherine’s Hospice, Scarborough, where I have been Hospice Physiotherapist since November 1991. Jean, who was diagnosed with breast cancer in 1987, wrote the article. It describes her cancer journey over the past 12 years.
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A question of faith for the Hindu patient
Kiran Sharma
pp 99-100
In order to understand the spiritual world of a Hindu person, one must accept that Hinduism is a culture and a way of life, as much as a religion. To the Western eye, Hinduism is characterised by a diversity of rituals, gods and beliefs. However, its basic tenet is the doctrine of reincarnation. The world is believed to be illusory and false, although the experience of living is real. Hindus are trapped and driven by false desires and the rewards that the world has to offer.
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A voice for the voiceless
David Oliviere
pp 102-105
One of the greatest achievements of the 20th century was the development of modern palliative care. ‘There is nothing in this earth more powerful or more revolutionary than a newly recognised idea or a situation seen in a new way ... (there are) men and women who have seen an area of need, unrecognised before, or an injustice that none have challenged, or who will not be silenced.’
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1st Annual European Course on Palliative Care for Children
Tomasz Dangel
pp 106-108
The 1st Annual European Course on Palliative Care for Children was held in Budapest on 27–31 August 1999. The course was opened by Dr Anikò Lèvai, wife of the Prime Minister of Hungary and was generously supported by the Open Society Institute (New York), the Hungarian Ministry of Health, OMFB Hungary, the Charity Know How Foundation (UK), Biotest Hungary, Roche Hungary, Pharmacia Upjohn and GlaxoWellcome Hungary.
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