There is an end to cure; there is no end to care.
Palliative and hospice care plays a crucial role in improving the quality of life of patients with life-limiting illnesses. This specialized form of care focuses on providing relief from the symptoms, pain, physical stress, and mental anguish associated with serious illnesses. While the concept of palliative and hospice care is gaining recognition worldwide, its understanding and implementation in the Philippines remains limited.
Despite efforts to improve access to these services, the majority of Filipinos do not have access to quality palliative and hospice care. A study conducted by Erfe and colleagues in 2020 revealed that only 10% of hospitals in the country have palliative and hospice care units. Moreover, the same study found that there is a significant lack of specialized healthcare professionals trained in palliative and hospice care.
A number of challenges hinder the development and implementation of palliative and hospice care. There is a perceived lack of awareness among the general population and even healthcare professionals about palliative and hospice care. Some doctors do not want to refer their patients to a palliative care specialist because they believe it means giving up and failing as a physician. Many people mistakenly believe that these forms of care are synonymous with end-of-life care or euthanasia, leading to reluctance in seeking or providing such services.
The shortage of trained healthcare professionals in palliative and hospice care results from the limited inclusion of palliative and hospice care in medical education. As a result, healthcare professionals often lack the skills and knowledge necessary to provide comprehensive palliative and hospice care to patients in need. The number of questions about palliative and hospice care principles in the physician licensure exam is very limited if we think of its applicability in the medical field where treatment failure at the end of life is inevitable.
The limited availability of resources is another major challenge. Palliative and hospice care requires the maintenance of specialized facilities, access to various medications for pain management, and support from allied health professionals such as psychologists and social workers. However, these resources are lacking in many healthcare institutions, making it difficult to provide comprehensive care to patients. The simple provision of pain-modifying opioids, even in large institutions, is lacking, making patients bear with pain and suffering for prolonged periods.
Cultural and religious factors also contribute to the slow implementation of palliative and hospice care in the country. Filipinos have a strong familial and religious support system, which can sometimes conflict with opting for palliative and hospice care. Many families prefer to care for their loved ones at home, with the belief that it is their duty to do so. This cultural norm limits the acceptance and utilization of palliative and hospice care services.
There are several potential avenues for improving palliative and hospice care in the Philippines.
Firstly, increasing awareness through education campaigns and public discourse is crucial. Efforts should be made to educate the general population, healthcare professionals, and policymakers about the nature and benefits of palliative and hospice care. This can help dispel misconceptions and foster a more accepting attitude towards these services.
Secondly, incorporating palliative and hospice care into medical education curricula can contribute to the availability of well-trained healthcare professionals. The Philippine government and medical schools should collaborate to include relevant coursework and training in palliative and hospice care to ensure that future healthcare professionals are equipped with the necessary skills.
Addressing the resource shortage issue requires both financial and institutional support. The government should allocate funds specifically for the development and maintenance of palliative and hospice care units in hospitals and healthcare institutions. Additionally, expanding the availability and accessibility of pain management medications is imperative to ensure that patients receive optimal relief from their symptoms.
Cultural and religious factors should be taken into account when designing palliative and hospice care services. Collaborating with local community leaders, religious organizations, and healthcare professionals can help bridge the gap between traditional and modern care approaches. By involving the community in the decision-making processes, a more culturally sensitive approach can be developed.
Despite the challenges faced by palliative and hospice care in the Philippines, there is a growing need for these services to improve the quality of life for patients with life-limiting illnesses. By increasing awareness, providing comprehensive education, allocating resources, and addressing cultural and religious concerns, palliative and hospice care can be better understood and implemented. The development and improvement of these services are not only essential for improving patient care but also for the overall well-being of families and society.