Prior to 2020, within many cultures, death was a sanitised topic and one that did not get much mainstream airtime. The global Covid-19 pandemic changed that, with conversations about mortality increasingly taking place within homes and around the globe. These conversations mirrored the ones had by the medical profession as medical and healthcare staff experienced levels of death that were, for many, unprecedented.
Held annually, the national Hospice Week (1–7 May 2022) is dedicated to highlighting the importance and nature of palliative care. However, the last while has seen many medical professionals become more and more aware of the need to work with a life-threatening diagnosis in a holistic manner; not only for the benefits afforded to the patient, but, so too, for the support it provides them.
Says Ewa Skowronska, CEO of the Hospice Palliative Care Association (HPCA), a registered NGO member organisation for South African hospices: “Palliative care is often understood to be solely care for the terminally ill. This is not correct. It is the provision of care for people whose life is threatened by a disease (which included Covid-19). This care is offered by a multi-disciplinary care team that can include a medical doctor, professional nurse, social worker, spiritual carer and home-based carers. The team works with the patient’s own specialist or oncologist to ensure a good quality of life for patients who have been diagnosed with life-limiting illnesses as well as to prevent and relieve unnecessary suffering.”
Hospices deliver palliative care in three main ways: home-based care for those who prefer to be at home (and can be), hospice community centres (Day Care Centres) for those who are able to travel to central points, and in-patient units for around-the-clock care.
According to Leigh Meinert, the Advocacy & Operations manager of the HPCA: “Despite the holistic care that palliative care provides, and the flexible nature of the services (home-based care being one of them), we unfortunately often hear of patients referred to members very late in their disease progression. This essentially deprives individuals of the quality of life that might be possible when facing a life-threatening condition as well as medical professionals of the support that is available to them when working with a patient with a life-limiting diagnosis.”
Dr Mark Hosking (MBChB (UCT), DA, DCH, DipMid, Dip Phil), works closely with Helderberg Hospice. Dr Hosking says: “Having a long standing and strong relationship with the hospice care teams, I have been exceptionally fortunate to confidently work with hospice for many years. The hospice delivers unique resources not easily replicated here in Somerset West. It allows me to easily co-ordinate care in the patient’s home that is professionally supervised by skilled nurses with a strong knowledge in palliative algorithms. The team also receives strong integral psychosocial support from social workers (also available in the patient’s home). This care then migrates from patient care to family care. It is 24 hours a day, seven days a week, and my patients feel very supported by this broad-based, wrap-around support.”
According to Skowronska, despite the quality of care provided, a perception still exists that hospice care is ‘second-rate'. In spite of the fact that in 2020, the fourth edition of the Standards for Palliative Healthcare Services was recognised internationally and accredited for four years by the global authority on standards development and assessment.
“This is the International Society for Quality in Health Care’s External Evaluation Association (IEEA). As the only bespoke and comprehensive set of internationally accredited standards that exists in South Africa for institutions providing palliative care, it was a critical achievement driven by the Hospice Palliative Care Association (HPCA), hospices and The Council for Health Service Accreditation of Southern Africa (COHSASA),” says Skowronska.
Dr Hosking agrees: “The hospice teams are proactive and able to network with any specialist or medical team negotiating best care – whether early and in need of interventions or later when terminal care takes priority. The team develops strong relationships with their patients, offering exceptional strength in enabling informed discussions which are often overlooked in other care dynamics.”
Dr Hosking concludes by stating: “Hospice multiplies my care exponentially.”
For more information about the HPCA or their members, visit http://www.hpca.co.za/