Integral ecology

Palliative care essential for public health, Secpal says

Francisco Otamendi-November 8, 2022-Reading time: 4 minutes

The need to recognize palliative care as essential for public health, an "essential approach" to improve the quality of care, will be the strategic line of the Spanish Society of Palliative Care (SECPAL) until 2025. On the other hand, universities such as Navarra, Francisco de Vitoria and CEU incorporate learning about palliative care.

This challenge requires awareness and the joint efforts of professionals, administrations and citizens "and its core must be the sick people and their families," said Dr. Juan Pablo Leiva, president of the palliative care society.

One of the priority objectives of this line of work is to achieve the involvement of the Ministry of Universities so that a truly effective plan can be implemented to guarantee undergraduate and postgraduate training in palliative care in all health-related disciplines.

These were some of the postulates defended in an event with which the scientific society culminated the activities developed in October to commemorate the month of palliative care. Held in the small amphitheater of the Official College of Physicians of Madrid (ICOMEM), the meeting brought together professionals from the fields of medicine, nursing, psychology and social work around a program in which the protagonists were patients and family caregivers.

"When you're not alone, it's less hard." "It's reassuring to know that someone is there to take care of you." "They helped us make sure he was in cotton wool until the end." "He was very vital and traveled almost to the last moment." "I learned to cry and breathe."

These are brushstrokes of the experiences which could be heard in the voices of Rosa Pérez, Mercedes Francisco, Elisa Nieto, Laura Castellanos, Consuelo Romero and Lilia Quiroz, during an event that served to pay tribute to the sick and the loved ones who are dedicated to their care, key elements in guaranteeing adequate palliative care.

"Palliative care support teams that go to the home are fundamental," said Consuelo Romero, family caregiver of María, a woman "with a great desire to live" who had highly complex metastatic ovarian cancer and who was able to maintain her independence and autonomy until a few days before her death thanks to the care of her family and the support and accompaniment of a home support team.

Inequity in the access to palliative care

However, despite the fact that palliative home care is "extremely beneficial for patients and their families" and allows the patient to stay at home as long as possible, in Spain it is not fully developed, as reported by Omnes several occasions.

This was recalled at this event by the nurse Alejandra González Bonet, and emphasized by the president of SECPAL, who highlighted the existing inequity in access to palliative home care 24 hours a day, every day of the year, a service that does not exist in all the autonomous communities.

"We cannot allow access to palliative care to depend on the zip code," said Dr. Juan Pablo Leiva, who appreciated the growing awareness of the importance of considering palliative care as a human right.

"We will all meet an end of life at some point, whether it is that of a loved one or our own. What unites us all is suffering. In palliative care we work on therapeutic presence, that presence that facilitates the encounter with the suffering person, without fleeing or fighting senselessly, or becoming paralyzed in the face of suffering," he stressed.

Patient associations

Over the next two years, the scientific society SECPAL will seek synergies between specific and general palliative care resources, as well as with the global community, to ensure that palliative care is recognized as essential for public health. This is a challenge for which it is necessary to "understand that promoting its development in our country is everyone's responsibility".

In advancing towards this objective, Dr. Leiva highlighted the leading role to be played by patient associations, which were represented at the commemorative ceremony by Andoni Lorenzo, president of the Spanish Patient Forum (FEP), who assumed this: "Our great claim has always been that patients should be in the places where decisions are made and health strategies are defined," he recalled.

Holistic" care

Dr. Magdalena Sánchez Sobrino, regional coordinator of Palliative Care of the Madrid Health Service, and Dr. Luisa González Pérez, vice-president of ICOMEM, also participated in the inaugural round table, both of whom agreed in highlighting the integral nature that defines palliative care. Faced with an advanced disease or with a limited life prognosis, "our whole being is affected, so people must be cared for holistically" [as a whole], stressed Sánchez Sobrino, who urged professionals, institutions and patient organizations to "work together" to achieve adequate development of palliative care.

For her part, Dr. González Pérez recalled that the College of Physicians of Madrid has recently set up the Scientific Committee on Care, as part of the ICOMEM campaign Care from start to finish.

"Care is an attitude, a message that we physicians want to send out to awaken society to the need to demand that it be a reality: care that must be structured, financed, at all stages of the disease and in all age groups, because the medicine of the future is a medicine of care," he stressed.

In some universities

"Unlike most European countries, Spain does not have a specialty in palliative medicine. This is perhaps the most critical point for the development of palliative medicine," Miguel Sánchez Cárdenas, a researcher at Omnes, pointed out some time ago. Atlantes Research Group (ICS) of the University of Navarra.

Well, this same university is one of the few with a compulsory subject taught in the sixth year, and which was included in the curriculum thanks to the students themselves, as explained by Dr. Carlos Centeno, who is in charge of the subject, to 'Redacción médica'. This same media reports that Dr. Centeno has asked himself: "Is it logical that students are asked about very specific aspects of Palliative Medicine in the MIR and have not been given any subject?

Another center that has also opted for this same signature is the Universidad Francisco de Vitoria, adds the publication, by incorporating this competence constantly between the second and sixth year, through simulation workshops, expert visits and internships, explains Professor Javier Rocafort.

On the other hand, third year students of the Degree in Nursing at the CEU Cardenal Herrera University have produced 32 videos, where they explain the benefits of palliative care, in addition to highlighting the work of health professionals in this specialty.

The authorFrancisco Otamendi

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