'Palliative care at the
end of life is inadequate in many parts of the world, for patients with all
types of illness. According to a global atlas published in January, 2014, by
WHO and the Worldwide Palliative Care Alliance (WPCA), only 20 countries have
palliative services fully integrated into their health-care systems, and 80% of
people worldwide do not have adequate access to opioid drugs for pain relief.
Palliative care is often thought of as alleviation of suff ering at the end of
life, when options for drug treatment have run out. However, as defi ned by WHO, palliative care
can also be “applicable early in the course of an illness, in conjunction with
other therapies that are intended to prolong life”. Palliative care should be
available to all patients with a chronic progressive illness whenever it would
alleviate suff ering, and should go beyond use of drugs
to manage symptoms to include practical and emotional support—eg, aspiration pneumonia
might be avoided with practical advice about eating, relationship advice can
help with sexual diffi culties, and counselling might ease anxiety".
"Palliative and end-of-life care should not be last or least"
Copyright © 2014 Elsevier Ltd All rights reserved.
texto completo em The Lancet Neurology, Volume 13, Issue 5, Page 439, May 2014
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