Relieving the suffering of dying: Home Palliative Care as a spiritual coping strategy

This article was exclusively written for The European Sting by Ms. Julyana de Souza Araujo, a third-year medical student at IESVAP. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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The World Health Organization (WHO) defines palliative care as an approach that improves the quality of life of patients and their families in the face of the problem associated with fatal disease by preventing and alleviating the suffering through early identification, evaluation and impeccable treatment pain and other problems, psychosocial and spiritual (1). In this view of care, preserving the dignity of the person in the final phase of his life becomes essential. Therefore, it is necessary to maintain the identity and integrity of the patient, preserving all that has meaning and value in his life, as well as the permanence in his home. Thus, it is important that health professionals are able to recognize the spirituality of each patient to use it as a coping strategy in the face of their difficulties. However, in practice, most people die in a hospital. In Brazil, unfortunately, the romantic tendency to die at home or anywhere that makes sense for your life is still unreachable. There are not enough resources and trained professionals for Palliative Care assistance for patients who wants to be treated at home. A new review, lead by Barbara Gomes, shows that by being followed by home palliative care teams, people with advanced disease see a double chance of getting better the symptomatic control instead of receiving conventional care elsewhere. Given the strong evidence of benefits, the authors recommend the need to invest in home palliative care and include its development in national health strategies, policies and programs (2). Thus, changes must occur, from the creation of public health policies that enable the application of death in environment outside the hospital to the training of health professionals, making them competent to meet the need that the patient demands. An example is the not-for-profit organization “Casa do Cuidar” (Care House), whose mission is the excellence of practice and teaching in Palliative Care and values ​​based on respect for patient autonomy. Therefore, health professionals should be trained to assist the needs of this population with fatal disease, while safeguarding the integrity of the patient with what is in accordance with their spirituality. Finally, when the patient’s spirituality is respected and the end of his life can be where he wants it, the suffering of dying can be alleviated. References (1) WORLD HEALTH ORGANIZATION (WHO). WHO definition of palliative care. 2019. Available at: <https://www.who.int/cancer/palliative/definition/en/&gt;. Accessed on: 24 Jul. 2019. (2) PORTUGUESE PALIATIVE CARE ASSOCIATION. Home palliative care doubles the chances of dying at home and reduces symptomatic burden for people with advanced disease. 2019. Available at: <https://www.apcp.com.pt/noticias/palliative-care-domain-duplicate-chances-of-dying-in-home-and-reduce-symptomatically-for-people- with-advanced-disease.html>. Accessed on: 24 Jul. 2019. About the author Julyana de Souza Araujo is a third-year medical student at IESVAP. Currently, she is Local General Secretary of IFMSA Brazil IESVAP and Coordinator of the project entitled HEARTS FOR THE HOMELESS BRAZIL in the state of Piauí, she is Secretary of the Joaquim Narciso Filho Academic Center, Treasurer at the Academic League of Pharmacology and Therapeutics of the Parnaíba Delta and Extension Director at the Academic League of Medical Propaedeutics of Piauí, where she developed the project “Who Loves Educates”. She is an education enthusiast and loves learning, believes that training health professionals is the key to improving the quality of life in Brazil.