How to provide care for patients suffering from terminal non-oncological diseases: barriers to a palliative care approach

Abstract

Despite the seemingly evident pertinence of palliative care for patients suffering from non-oncological long-term life-threatening diseases, everyday clinical practice is far from that assumption. This study aims to explore palliative care service provision for these patients in Spain. Patients, family caregivers and healthcare professionals were interviewed, individually or in a group, aiming at identifying barriers in the provision of care and strategies to overcome them. Ritchie and Spencer's framework was used for data analysis. The barriers identified were as follows: lack of clarity about prognosis, the hegemony of the curative approach, avoiding words and the desire to cheat death. Provision of palliative care services for these patients should be guided by the characteristic trajectory of each type of disease. Even if healthcare systems were capable of providing specialized palliative care services to this large group of patients, other barriers should not be overlooked. It would then seem appropriate to provide therapeutic and palliative care simultaneously, thus facilitating adaptation processes for both patients and relatives.

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

“…However morphine consumption per capita was below the European and global average [254]. Fears about death were found to be a major barrier to good EoL care [255].…”

62 Barriers to Optimal Palliative Care of Lung Transplant Candidates

“…A number of common themes have emerged from these studies, including (1) a lack of awareness of palliative care as a field, and inadequate understanding of palliative care needs at a public and governmental level; (2) limited fi nancial and material resources; (3) inadequate professional training programs; and (4) problems relating to opioid availability. [14][15][16][17][18][19] This study has limitations. First, the proportion of individuals responding to our survey was low.…”

Palliative Care for People With Hepatocellular Carcinoma, and Specific Benefits for Older Adults

“…81, 82 Designing care delivery models specifically based on disease stage will not meet the needs of all patients, as there is likely to be variation among palliative care needs, particularly among older adults with other chronic conditions. Furthermore, there are specific challenges that span the course of illness that palliative care may help address (bottom-most row of table 2), which are described here.…”