Health Tips

According to MOH,

A global cross-sectional study in 2018 also found that in Malaysia, there were 30,780 children requiring palliative care.¹ So, what is Palliative care? 

PALLIATIVE CARE ^1,2,3

Palliative care is a specialised medical approach for patients with serious illness by emphasising on improving patients’ quality of life. Patients will be receiving care to control their symptoms and intended treatment to cure their chronic medical conditions. 

According to MOH, initially, palliative care was mainly indicated for the advanced incurable cancer patients. However, the scope has been expanded to include other conditions such as those with life-threatening chronic disease, patients with incurable genetic medical conditions, serious organ failures patients and elderly suffering from multiple medical conditions and frailty.

Therefore, palliative care works best when it is introduced soon after the patient is diagnosed with advanced illness.

SYMPTOMS OF PALLIATIVE PATIENTS ³

• Pain
• Nausea or vomiting
• Constipation
• Difficulty breathing or breathlessness 
• Depression and anxiety
• Loss of appetite for food
• Trouble sleeping and fatigue

MYTHS AND FACTS ⁴

1. Myth: Palliative care hastens death.

Fact: Palliative care does not hasten death! Palliative care aims to provide comprehensive comfort to patients in order to achieve their best quality of life until the end of life.

2. Myth: Palliative care is only for cancer patients.

Fact: Palliative care is expanded to involve all patients with chronic illness and elderly with multiple comorbid diseases! Both patients and family members or caregivers may benefit from palliative care.

3. Myth: People in palliative care will die of starvation if they stop eating. 

Fact: Patients suffering from chronic illness normally will not experience hunger or thirst like those healthy people do. Therefore, those who stop eating may die of their chronic illness, not starvation.

4. Myth: Palliative care means my doctor has given up and there is no hope for me.

Fact: Palliative care ensures that patients with chronic diseases will receive the best quality of life. It aims to provide more hope for patients about living life but less about cure.

5. Myth: I’ve let my family member down because of dying at hospital.

Fact: Depending on the patient's situation, he/she may need some support which can only be done at the hospital. However, the objective is still to deliver the best care for patients  regardless of setting.

HOSPICE CARE ²

Like Palliative care, hospice care emphasises on comfort, care and quality of life of patients with advanced illness who are near the end of life. However, hospice care does not focus on curing a chronic disease or a patient has the option to not receive certain treatments. Generally, hospice care is provided when a doctor believes that the patient has less than 6 months of duration left if the chronic illness runs its natural course.

MYTH AND FACT ⁵

1. Myth: Hospice care is only for people giving up on life.

Fact: Hospice care is not about dying. It is about maximising patients' life to the fullest, with the time they have left. Multiple research studies show that patients who are terminally-ill and choose hospice care often live longer and have a better quality of life than those who choose aggressive end-of-life medical care.  

2. Myth: Choosing comfort care means giving up controls.

Fact: Patients and their family members or caregivers will make the final decision about when to choose hospice care. The best care happens when we listen first then coordinate with the patient, family and doctor.

3. Myth: You can’t go back, once you made a decision on hospice care!

Fact: Patients can actually reverse the hospice participation at any time. They may decide to seek curative treatment again. In addition, patients still can reapply for hospice care at a later time.

4. Myth: Hospice care is only for people who have few days or weeks left to live.

Fact: While hospice certainly helps patients and families during a medical crisis, the fullest benefit occurs when pain and symptoms are managed and patients have time to make personal and spiritual connections. 

5. Myth: Hospice care and palliative care are the same.

Fact: In fact, both provide comprehensive comfort care for those with serious illness. However, hospice only starts after the decision to end treatment for a terminal illness and when it's clear the person will not survive. While palliative care can start at the time of diagnosis and treatment. There are tables attached below showing the differences between palliative care and hospice care. 

WHAT ARE THE DIFFERENCES BETWEEN PALLIATIVE CARE AND HOSPICE CARE?

Table taken from: https://www.compassus.com/services/hospice-care/10-hospice-myths 

Table taken from: https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

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References:

1. Ministry of Health (MOH). National Palliative Care Policy and Strategic Plan 2019 - 2030. 2019. Available from: https://www.moh.gov.my/moh/resources/Polisi/BUKU_NATIONAL_PALLIATIVE_CARE_POLICY_AND_STRATEGY_PLAN_2019-2030.pdf 

2. National Institute of Aging (NIH). What Are Palliative Care and Hospice Care? 2021. Available from: https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

3. Mayo Clinic. Palliative care. 2017. Available from:  https://www.mayoclinic.org/tests-procedures/palliative-care/about/pac-20384637 

4. Canadian Virtual Hospice. 10 Myths about Palliative Care. 2019. Available from: https://www.virtualhospice.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/What+Is+Palliative+Care_/10+Myths+about+Palliative+Care.aspx 

5. Compassus. 10 Myths and Facts About Hospice Care. 2021. Available from: https://www.compassus.com/services/hospice-care/10-hospice-myths 

Written by

Ms Ker Chin Woon, Carina