The Spanish health ministry is to launch a national plan on palliative care aimed at improving the quality of life of terminally ill patients on a “rational, planned, and effective” basis and at ensuring that palliative care constitutes a “legal and individual right” of patients.
Special attention will also be paid to improving the quality of life of relatives of terminally ill patients. The report highlights the necessity of a basic training in palliative care for health professionals. The development of specific programmes, with qualified professionals and intervention at all healthcare levels, is encouraged. This report now has to be discussed by the health departments responsible for the different Spanish autonomous communities (or regions) for definitive approval.
The health ministry has announced that the plan will cover all patients from the public health network on a free basis. The plan intends to achieve a better coordination between primary and specialised healthcare levels in order to provide integrated and personalised care to patients.
As far as primary health care is concerned, patients who prefer to stay at home during their last period of life will receive an active home health care by specific teams trained in palliative care.
As far as hospitalisation is concerned, the report says that the “target” units where terminally ill patients are usually treated (oncology, haematology, radiotherapy, gerontology, internal medicine, general surgery, and emergency) will undergo changes aimed at providing more comfort. Hospitals may introduce such innovations as individual rooms for dying patients, peaceful hospital areas, specific nursing care, and special diets.
The plan envisages the establishment of specialised, interdisciplinary, palliative care teams consisting of a physician, a nurse, a social worker, and a psychologist. These professionals will administer appropriate treatment to mitigate pain and other problems of the terminal illness and will provide psychological support for both the patient and the relatives.
Spain currently has 208 palliative care teams. These teams last year attended 23000 terminally ill patients; over 80% of these patients had cancer.
Figure.
CHRIS SATTLBERGER
Elderly people will be among those who will benefit from a new plan for improving palliative care in Spain