Cuidado paliativo não é abandono do paciente | Daniel Forte

Summary

In this insightful discussion, Dr. Daniel Forte, head of palliative care at Sírio-Libanês Hospital and a specialist at the Hospital das Clínicas in São Paulo, delves into the importance and evolution of palliative care. He addresses misconceptions about its role, emphasizing that palliative care is not about abandoning patients but improving their quality of life, especially in the face of serious illness. Dr. Forte also highlights the need for a multidisciplinary approach, better integration into medical education, and increased awareness in both public and private healthcare systems. The conversation stresses the vital role of compassion and comprehensive care for patients in their most challenging times.

Takeaways

• 😀 Palliative care is a medical approach focused on alleviating suffering for patients with serious illnesses, even when no cure is possible.
• 😀 The history of palliative care dates back to the 1960s in England, but Brazil started adopting it much later, in the 1990s.
• 😀 Palliative care is often misunderstood, with some associating it with 'giving up' on patients, although its goal is to improve quality of life and manage symptoms.
• 😀 The specialty of palliative care is still underdeveloped in Brazil, with significant disparities in access, particularly between the public and private healthcare systems.
• 😀 Palliative care involves a multidisciplinary team, including doctors, nurses, social workers, and psychologists, to address the physical, emotional, and spiritual pain of patients.
• 😀 The World Health Organization (WHO) recognizes palliative care as a vital service, but Brazil lags behind in integrating it into the national healthcare system.
• 😀 Doctors in Brazil often have limited training in palliative care, leading to insufficient support for patients who require this care.
• 😀 Morphine and other analgesics are underused in Brazil, with consumption rates far below the WHO's recommended levels, contributing to untreated pain for many patients.
• 😀 Palliative care should not be viewed as exclusive to elderly patients or those at the end of life—it can benefit anyone with a serious illness, regardless of age.
• 😀 The future of palliative care in Brazil requires better policy, more widespread training for healthcare professionals, and a more structured system to support patients in need.
• 😀 There is a need to shift the perspective of healthcare providers, moving away from a solely curative approach towards a more holistic model that prioritizes patient comfort and quality of life.

Q & A

What is the main topic discussed in the conversation?

The main topic discussed is palliative care, its evolution, challenges, and its role in providing care for patients with serious or terminal illnesses.

What is palliative care, according to Dr. Daniel Forte?

Palliative care is a medical approach aimed at providing comfort and improving the quality of life for patients suffering from serious illnesses. It addresses physical, emotional, and spiritual pain, not just at the end of life but also during the course of illness.

How did the concept of palliative care evolve historically?

Palliative care began in the 1960s in England, initially as a movement to provide care for patients with terminal diseases who could no longer receive specific treatments. It expanded over time to address the total suffering of patients, not just physical pain.

What are some challenges faced by palliative care in Brazil?

In Brazil, there is a significant lack of national policy for palliative care, with services being more available in private healthcare compared to the public system. Additionally, there is a shortage of specialized teams, particularly in the northern region of Brazil.

How does palliative care address pain management, particularly with the use of morphine?

Morphine is a critical medication for managing pain in palliative care. However, Brazil consumes far less morphine than recommended by the World Health Organization, indicating that pain management is often insufficient.

What is 'total pain' in the context of palliative care?

Total pain refers to the multidimensional nature of suffering experienced by patients, including physical, emotional, social, and spiritual pain. Palliative care seeks to address all these aspects to improve the patient's quality of life.

What role does a multidisciplinary approach play in palliative care?

A multidisciplinary approach in palliative care involves a team of specialists, including doctors, nurses, physiotherapists, and psychologists, who collaborate to provide comprehensive care. This approach ensures that all aspects of a patient's suffering are addressed.

How do families generally react when palliative care is suggested for a patient?

Many families initially misunderstand palliative care, often perceiving it as giving up on the patient. However, once they understand the situation and the purpose of palliative care, many accept it as the best option for their loved ones.

Is palliative care provided only to terminal patients?

No, palliative care is not limited to terminal patients. It is provided to anyone with a serious illness, regardless of whether they are at the end of life. The goal is to manage symptoms and improve the quality of life.

What does Dr. Daniel Forte believe about the future of palliative care in Brazil?

Dr. Forte envisions a future where palliative care becomes more integrated into Brazil's healthcare system. This includes training healthcare professionals at various levels, from general practitioners to specialists, to recognize when palliative care is needed and provide it appropriately.