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Patients need peace in the last days of life

By Vision Reporter

Added 13th May 2009 03:00 AM

Have you ever lost a loved one to cancer or AIDS? Did you have help to control pain and other symptoms? Did you have a sympathetic and honest adviser? If not, you will know the terrible suffering for your loved one and family at a time when you should hav

Have you ever lost a loved one to cancer or AIDS? Did you have help to control pain and other symptoms? Did you have a sympathetic and honest adviser? If not, you will know the terrible suffering for your loved one and family at a time when you should hav

By Dr. Anne Merriman

Have you ever lost a loved one to cancer or AIDS? Did you have help to control pain and other symptoms? Did you have a sympathetic and honest adviser? If not, you will know the terrible suffering for your loved one and family at a time when you should have peace. This terrible situation is happening all over Africa and the World Health Organisation has been urging governments to take action.

This week is Palliative Care Week and this year’s theme is: “Adding life to days, not just days to life”. Palliative care was introduced to Uganda with the founding of Hospice Africa Uganda (HAU), in 1993. Dame Cicely Saunders, founder of the modern Hospice movement, conceptualised the hospice approach as follows:

“You matter because you are you, you matter to the last moment of your life and we will do all that we canto help you to live until you die.” Hospice Uganda introduced modern methods of pain control in an affordable way and this was embraced by the Ministry of Health at a time before anti-retroviral drugs, when many Ugandans were dying in severe pain.

Today, through palliative care, it is possible to control pain and symptoms, allowing holistic care to be delivered when the patient and family are at peace. By training caring teams in support organisations, this form of care will soon be available for all.

“Hospice” means “hospitality” and today hospice is no longer a home or a building. It is now a philosophy of care, given to the patient and family, when critically ill or at the end of life.

Studies have found that the majority of Africans would like to die in their own homes, when services are available to support them. Palliative care provides pain and symptom control through a team of nurses, clinical officers, doctors, social workers and spiritual advisers, who work with the patient and family.

The patient becomes a guest and makes decisions on life and care. The palliative care team becomes a caring friend of the family and is available for consultation. This is a precious time of life for the patient and family when disagreements can be resolved and peace can be made with the family and God.

Palliative care can be delivered through a hospice or other establishment where the health professional has received special training.

Palliative care is available at hospices in Makindye, Mbarara and Hoima, Jinja and Mbale. It is also available in 33 districts, through health workers in government facilities and mission hospitals.

The Ministry of Health has supported the importation of affordable morphine, an essential pain-control drug. Now pain can be relieved in the home.

Through village leaders, Hospice has sought out community volunteers. These are given special training and supported by Hospice. Patients in need are visited at home, given basic nursing and referred to the Hospice team. The team then goes to the home, and working with the volunteer, brings physical relief and addresses social, spiritual and other problems.

When palliative care is given, the patient, now free of pain and symptoms, is often able to live life normally again and some even go back to work on their farms or to their businesses while on morphine.

Morphine is a controlled drug and has to be handled carefully. But it does not hasten death. When the correct dose is given, normalcy returns; the patient will eat and sleep better and usually lives longer.
The writer is the founder and director of policy and international programmes, Hospice Africa in Uganda

Patients need peace in the last days of life

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