Table 3 Challenging the WHO definition of palliative care
“Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”. | |
|---|---|
Part of definition | Practical challenges in PC for patients with SUD+ |
“their families” | There is often no social network or it is very (time- and emotionally) demanding to involve them in the provision of palliative care. |
“life-threatening illness” | Patients with SUD+ can suffer from life-threatening diseases, such as cancer or COPD. However, SUD itself can be a life-threatening illness, too, but is not always recognized as such, partly because addiction care is recovery-focused. Such patients suffer from far-progressed, somatic deterioration instead of specific disease(s) and therefore, might be harder to identify as being in need of PC. |
“prevention and relief of suffering by means of early identification” | Patients often suffer from a lot of pain. Since patients often still have active SUD, relief is hard. Prevention (proactive care) is challenging due to, among other things, late symptom- and disease presentation. |
“impeccable assessment and treatment” | As many patients with SUD+ are limited or restrained in their expressions and experiences of symptoms and disease, assessment and treatment of pain and multidimensional problems and needs are hindered. Other barriers are that the SUD is not always known or knowledge of HCP/VE about symptoms is limited. |
“other problems, physical, psychosocial and spiritual” | Caring for this patient group also comes with ethical problems. |