Dr. Cristina Guimarães Savoi, doctor and service coordinator at Hospital da Baleia explains this medical specialty.
The word “palliative” derives from Latin pallium, which means mantle, in an allusion to the idea of protection and welcome. The proposal of Palliative Care is to rescue the true essence of medical art, in its original intention of caring, regardless of the possibility of cure. Caring for a sick individual, considering their particularities, opinions and desires, far beyond their history of illness. Know and value the patient's biography, incorporate the attention of family members, the social and cultural aspects of the sick person. Preserve the patient's identity. Treat effectively the many physical symptoms, such as pain, shortness of breath, vomiting, which torment patients and limit their quality of life. Taking care of emotional issues, fears, frustrations, difficulties and expectations that permeate the lives of patients who are faced with the real possibility, and often close, of death. Give the patient dignity. Facing finitude as natural and sacred, part of the process of living. Respect the subject's autonomy and his right to decide on issues related to his body and his life. In summary, the main objective of Palliative Care is to ensure that the patient lives as actively as possible until the end, with minimal suffering.
For this to be possible, the performance of a multiprofessional team with solid technical and human background is essential, able to meet the diverse needs of the patient and his family. The relationship of the health professional with the patient and his family is based on trust and respect, generating shared decisions whose focus is the maximum possible quality of life. Clear, honest, empathetic and compassionate communication makes care possible in all its breadth and complexity. Palliative care also includes assistance for bereavement, recognizing the importance of the extension of the team's performance, even after the patient's death.
The challenges are not few. A good part of the population is unaware of the existence and meaning of this care. There are a number of myths and untruths about the topic. Many think that palliative care is reserved only for cancer patients, or only for 'terminal' patients. However, they are applicable in diseases of the most different natures, such as organ failure - kidney, liver or heart failure, chronic infectious diseases such as AIDS, severe respiratory diseases, neuromuscular diseases, dementias and all those that, due to their progressive and incurable character, threaten the continuity of life. The benefit of the palliative approach must be offered early, preferably from the diagnosis of the disease. Another common mistake is to think that patients in palliative care cannot receive specific treatments for the disease. What is proposed is simultaneous care, in which both disease-modifying treatments and treatments with a palliative approach are offered concurrently, according to the demand of each patient and according to the stage of the disease.
Modern palliative care was born in the late 1960s, in England. In several countries, there are already public policies that guarantee the right to this type of assistance. In Brazil, we have a long way to go before palliative care is available nationwide.
Palliative Care at Hospital da Baleia:
Baleia has humanized care in its DNA. Therefore, it was easy to include this clinic in the list of services offered to those who need it most. The Célia Guimarães Diniz Ward, recently inaugurated for the treatment of COVID-19, will later be dedicated to the specialty's activities. There will be 34 beds in a modern and comfortable space to treat patients as long as they need.