WHAT IS PALLIATIVE CARE?
The World Health Organization (WHO) defines palliative care as follows: “Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illnesses, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial, and spiritual problems.”
The key characteristics of palliative care services, as emphasized in the above definition, can be summarized as follows:
Life-threatening illnesses (primarily cancer; also stroke, neuromuscular diseases, certain lung conditions, etc.)
Patient and family (a holistic approach that considers the patient and their relatives as a whole, addressing the needs of both)
Physical, psychosocial, and spiritual problems (recognizing that beyond physical symptoms, patients also face psychological, social, and spiritual challenges that need attention)
Prevention and relief (even when symptoms cannot be entirely cured, efforts are made to prevent and alleviate suffering)
Improving quality of life (supporting every effort that enhances the patient's quality of life, beyond just medical treatment)
Approaches aimed at improving the quality of life of patients facing life-threatening diseases, along with their families, throughout the course of illness, are becoming increasingly important. Although relatively new in our country, palliative care services are rapidly expanding. These services are currently being delivered in many centers by effective multidisciplinary teams.
As emphasized in the WHO definition, palliative care is not a single-direction effort that can be sustained solely by healthcare institutions. The concept of care has shifted from a patient model focused only on physical symptoms and addressed primarily by healthcare professionals to a more comprehensive model that evaluates both the patient and their family. This model seeks solutions not only for physical symptoms but also for psychological, social, and spiritual problems, even with small efforts to improve quality of life. It provides support until the end of life and even offers bereavement support to surviving family members afterward.
By definition, palliative care must be multidisciplinary, as healthcare institutions and professionals alone cannot address all the above-mentioned challenges. A well-structured palliative care system must include not only health and social service institutions but also municipalities, NGOs, and foundations. In fact, palliative care inherently involves volunteerism and philanthropy.
Palliative care activities at Gaziosmanpaşa University began in 2010 with regular meetings. Under the umbrella of the Palliative Care Working Group, training meetings were held, patients were discussed in a multidisciplinary manner, and research studies were conducted.
Since palliative care is still a relatively new concept, education has been identified as a primary focus at the Palliative Care Training and Research Center. Therefore, the center continues to offer educational programs aimed at patients and their families, students, and healthcare personnel in a multifaceted manner.
Palliative care aims to evaluate the patient through a holistic approach. To achieve this:
It must be patient-centered,
Evaluate the patient within their family and social context,
Address physical symptoms,
Include a psychological dimension,
Identify and meet social needs,
Incorporate spiritual and religious aspects.
Palliative care must be carried out through multidisciplinary and interprofessional coordination. Depending on the needs of the patient and their family, the care team may include:
Physicians
Nurses
Social workers
Religious/spiritual care providers
Dietitians
Physiotherapists
Volunteers
Non-governmental organizations
... and others.
Patients should be supported in spending their final days in their preferred environment. To achieve this, the healthcare system and personnel must provide appropriate support.
Key services that can meet the needs of family members during this time include:
Training for caregivers,
Home care services,
A 24/7 accessible support unit.
At the Palliative Care Center:
Patients and their families receive education,
Students and healthcare professionals are trained,
New information on palliative care is shared,
Research is conducted to address the needs of society related to palliative care,
Physical, psychological, social, spiritual, and financial needs of patients are identified and addressed,
Nutritional support is provided,
Awareness is raised in society through events like charity sales, artistic activities, and seminars,
Efforts are made to spread palliative care services throughout society and to promote volunteerism and foundation-based support.
Additionally, the center provides support to family members and caregivers throughout the illness and even during the bereavement period after the patient’s death.
Since 2010, the Palliative Care Working Group has been organizing regular training sessions, including:
Weekly meetings discussing cases and planning new research,
Presentations from different disciplines focusing on the palliative care perspective,
International training for the working group,
A nursing education seminar to raise awareness of palliative care,
A two-day "Palliative Care Course" in May 2015 with participation from all stakeholders,
A palliative care course integrated into the 4th-year general surgery internship in the Medical Faculty curriculum for the past four years,
A 15-day elective theoretical and practical internship in palliative care offered to 5th-year medical students since the 2013–2014 academic year,
A 28-hour elective palliative care course introduced in 2014–2015 at Tokat School of Health Nursing Department,
Inclusion of palliative care as a university-wide elective course in the 2015–2016 academic year,
Training sessions provided to healthcare personnel to enhance their knowledge in this field.
The aim of the Palliative Care Practice and Research Center is to establish a community-based, region-specific, scientific, and dynamic palliative care service that meets the needs of Tokat and surrounding areas.