Tag: palliative care

Terminally Ill Patients Need More than Prayer from Spiritual Leaders

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A study conducted among advanced cancer patients in Soweto has found that most patients who received palliative care and are at the end of life, have spiritual needs beyond regular prayers from spiritual leaders. Furthermore, patients who received religious or spiritual care had less physical pain, used less morphine and had higher odds of dying where they wish than those who did not.

The study involving 233 participants was conducted by a team of local and international experts led by Wits researchers.

Lead researcher Dr Mpho Ratshikana-Moloko from the Centre for Palliative Care in the Faculty of Health Sciences at Wits University says that previous research has shown that religion and spirituality are important to most patients facing life-threatening illnesses. However, this study probed further.

Using the African Palliative Care Association Palliative Outcome Scale, the research confirmed previous international findings that nearly 98% of the participants had a religious or spiritual need.

The most common spiritual need expressed by patients in Soweto was “seeking a closer connection with their God” and “forgiveness for sins”, says Ratshikana-Moloko. This finding is of significance because it calls on faith leaders to provide relevant support that responds to the needs of patients. This research-led intervention empowers leaders to move beyond prayer, explains Ratshikana-Moloko.

“This is the first study to assess the spiritual and religious needs, and religious and spirituality care provided to advanced cancer patients who received palliative care in Soweto,” says Ratshikana-Moloko.

Since the study was concluded in 2018, Wits University has developed a course in Spiritual and Chaplaincy in Palliative Care. The first cohort of faith leaders from all religious backgrounds completed in September 2023.

Palliative care to increase

Palliative care is one of the key pillars in illness management among terminally ill patients who are judged by a specialist physician as unlikely to benefit from curative-intent therapy. Often, patients are unlikely to survive beyond six months.

The South African National Policy Framework and Strategy for Palliative Care (2017–2022) incorporates spirituality into health care. However, palliative care services in South and southern Africa and elsewhere, rarely address these needs, despite available policies, guidelines and evidence.

“We have to implement what we know. The integration of spiritual care within the clinical care setting is recommended,” Ratshikana-Moloko.

South Africa faces a heavy burden of communicable and non-communicable diseases. One in six deaths globally is due to cancer, and cancer diagnoses are expected to increase by 70% in the next two decades, especially in low- and middle-income countries.

“Failure to identify and address the religious and spiritual needs of terminally-ill patients may increase distress and suffering,” Ratshikana-Moloko.

Hospice Palliative Care Association Rebrands as the Association of Palliative Care Centres

As of the 1st of September 2023, the Hospice Palliative Care Association (HPCA) is known as the Association of Palliative Care Centres (APCC).

“This rebranding is not just a visual change,” says Ewa Skowronska, CEO of the APCC. “It is an important message to all medical professionals and the public that our members (many of whom still refer to themselves as hospices) offer quality, specialised and expert palliative care services. Too many people equate hospice with end-of-life only and many medical professionals refer very late. This leads to thousands of patients, and their loved ones, missing out on the holistic support that palliative care provides – support that, ideally, should be from diagnosis of a life-threatening illness and not solely in the last few days of life.”

The rebrand includes a new logo element that reflects that palliative care can be provided alongside curative treatments and into end-of-life care, including bereavement support (if needed). 

“Our members adhere to the Standards for Palliative Healthcare Services, 4th edition, 2020 approved by the Council for Health Service Accreditation of South Africa (COHSASA) and the International Society for Quality in Health Care (ISQua),” says Leigh Meinert, Advocacy and Operations Manager of APCC. “This is important as sometimes there is a perception that our members are only servicing patients who do not have private healthcare support and might not be at the same level as private organisations. In reality, they have decades of palliative care experience, and compliance with these Standards ensures an ongoing level of excellence.”

As much as 90% of APCC member’s services are provided to the patient in the comfort of their own home. The patient’s loved ones are also supported by way of an interdisciplinary team. Such a team typically consists of a medical doctor, nurse, social worker, and home-based carers who can work alongside the patient’s healthcare professional and support quality of life.

Palliative care covers conditions such as HIV/AIDS, drug-resistant TB, chronic respiratory diseases, cardiovascular and neuromuscular diseases, MND and more. “Both adults and children are catered for,” says Meinert. “While patients can move in and out of a palliative care service, they may remain beneficiaries of the services for as long as they (or their loved ones) need or wish to.  Patients may be discharged from the service if they are doing well and able to function independently.  This is always negotiated between the patient, family, and members of the care team. We encourage patients to engage with an APCC member from the point of diagnosis as this helps to dispel fears and provides insight into the holistic services that can be offered. We believe that all patients have benefitted from an improved quality of life through the supportive care received from APCC members.”

“APCC has a cloud-based patient care monitoring, evaluation and reporting system able to report in detail on interventions given to any patient,” says Skowronska. “Our members are comfortable working alongside the primary clinician or specialist.  They can provide a supportive extension of care to the patient and their loved ones and, in most cases, the APCC members inter-disciplinary teams collaborate and work alongside the referring doctors who are treating the patient. They also provide supportive care to the patient’s loved ones. This may include advanced healthcare planning, as well as psychosocial and spiritual support.” 

“Our palliative care definition says it all,” concludes Meinert. “Palliative care is the physical, psychological, social and spiritual care provided by an interdisciplinary team of experts to anyone with a life-threatening illness and their loved ones. Care is offered from the point of diagnosis and extends to bereavement support if needed. Over 90% of the care that APCC members provide is home-based with a focus on promoting quality of life.

We sincerely hope that this rebranding results in more people receiving the support that they so desperately need during some of the most difficult times in a person’s life.”

For more info, visit www.apcc.org.za