Cure, even when maybe it is no longer possible to heal. We are faced with a right sanctioned by law. It is necessary to focus on palliative care That, precisely as a definition, take care of all the physical, psychological, social and spiritual needs expressed by the person in its entirety. Strengthening palliative care in Italy therefore means Investing in human dignityimprove the quality of life and build a more equitable health and close to people.
But be careful. However, the way to go is still long and difficult. Fifteen years by the 2010 law, the process is far from being completed, strongly conditioned by territorial inequalities, lack of specialized personnel, lack of health policies adequate, Cultural and social barriers. The SICP – Italian Society of Palliative Care Recalls.
Services to improve
According to the data of the scientific society, out of 590 thousand adults who would need it, only 1 in 4 patients It actually has access to specific paths of palliative care. Not only that. There is no early vision of need, the reporting to palliative care is late and The law is guaranteed only to those in front of them a few days of life. And, even in this case, it concerns 68% of patients who need it.
The data testify to the lack of shared forms of care, consultancy and outpatient, which represent the part not only more relevant numerically, but of greater meaning from the point of view of control of the clinical government of patients. And that would guarantee one prevail of patients.
Regional and personal differences lacking
Always according to SICP’s analysis, only 9 regions fully satisfy the needs of home palliative teams and only 5 out of 21 regions have structured the intra and extra hospital consultancy activity for early taking charge, 3 out of 21 the outpatient level.
Again, the lack of specialized personnel A fundamental obstacle remains: currently, 50% of the necessary doctors are missing (750 vs 1,600 requested) and two thirds of the nurses (1,500 vs 4.550 requested). A deficiency that strongly penalizes access to palliative care, diverting the demand for care towards other forms of inappropriate care and assistance. The integration policies between the systems and the transversal use of resources is missing completely.
He declares Gianpaolo Fortini, president of the SICP:
“Despite being recognized as a universal right by law, palliative care remain inaccessible For most people who need it. It is a fact that we continue to record, due to structural, organizational and cultural deficiencies that limit access to services. As scientific society we monitor carefully and support the accreditation paths of the networks, as is happening in the Lazio region which is carrying out a significant work with results that will act as a lighthouse for other regions “.
Not just tumors
Failure to access palliative care does not concern only people with advanced oncological pathologies, to which they often mistakenly associate with exclusivity, but also patients with chronic and degenerative diseases.
To date the 70% of non -oncological patients They are excluded from the care and assistance services, despite the law sanctioned by law. Patients with chronic diseases such as advanced heart failure, chronic respiratory diseases, dementia and degenerative neurological diseases such as Alzheimer’s, terminal renal failure, cystic fibrosis and other rare diseases.
Explains Marta De Angelis, responsible for Sicp communication:
“These patients often face years of suffering, limited autonomy, health and welfare needs without adequate support, with unsuccessful symptoms and families, where they exist, leave only to face the emotional and practical weight of the disease. It is important to build synergistic connections between the different scientific societies and professional orders; in this sense the recent first call of the general states of the palliative care, which has seen the most involved by Sicp. of ten scientific societies and the National Federation of professional nursing orders “.
Not only end of life, early care is needed
Palliative care are not just an answer for the end of life: they represent a accompanying care path global that can start early in the patient’s clinical history, improving the quality of life For years. A fundamental approach to manage complex symptoms and support the patient and his family In all phases of the diseasenot only in the terminal phase and in strong integration with the other specialists and services that deal with the sick person. However, currently, the average duration of the palliative care paths is often limited to a few days or weeksbecause they are mostly activated only in the last days of life.
The Vice-President Sicp, Danila Valenti concludes
“This late approach frustrates the potential of multi -professional skills of palliative care, which should instead accompany the patient from the early stages chronic disease, improving the quality of life for months or years. One of the main commitments of SICP is to invest resources and collaborate in a constructive way with the universities and the 15 specialization schools in Italy to increase the attractiveness of the discipline e Enter professional resources in the networks. A law is not enough, a change of perspective is needed: palliative care are not an extreme act, but a right of continuity and therapeutic appropriateness “.
The important thing is to remember that early palliative care and if possible simultaneously with other therapies represent an organizational model aimed at guaranteeing the global taking charge of the patient through an ‘continuous, progressive and integrated assistance Between oncological therapies and palliation, when the goal is no longer only and mainly the patient’s survival.
The purposes of early and simultaneous palliative care are
- the global taking charge of the patient, caregiver and family;
- the treatment of all symptoms, including pain;
- The accompaniment of the patient’s psychological and spiritual experience during the most advanced phases of illness.
So it must be remembered that palliative care they are a right of all, payable in every phase of life and disease and in every place of care. And that improve life, not only the end of life, through the global taking charge of people with chronic and/or oncological diseases in an advanced phase as well as support and support for their families.
