Planning for end-of-life care

Planning in advance end-of-life care is one of the most innovative topics, when addressing the subject of palliative and dementia care, which is why the «Palliative and dementia care module» was one of the symposia which involved most discussion under Leaping Forward, at Hospital da Luz.

Why do we avoid talking about the end of life, even when we know it is drawing near? Why do other health professionals avoid discussing with us the subject? Why does society overall refuse to address the issue? At the «Palliative and dementia care module», held today in Auditorium 3 at Hospital da Luz, under Leaping Forward international medical congress, experts in this field sought to find the answers to these and other questions, they discussed different experiences and pointed out innovative and more effective courses for addressing this reality.

José Luis Pereira, specialist of Portuguese background, head of the palliative care network for the Ottawa region, underscored the importance of planning ahead when it comes to end-of-life care, and highlighted the need for such planning to include talking to family and friends, and appointing a tutor to help with decision-making in case of personal disability; to include discussing with health professional the progression of the disease and the need for medium and long-term care; to include rational management of financial resources, according to such care requirements; and include a written document, if that is the patient's will. «Planning end-of-life care is not only about writing up the will. It is much more. It involves discussing the matter with all stakeholders», José Luis Pereira underscored.

Dr Pereira introduced a Canadian project being conducted in this medical field, and described the campaign which is currently going on in the country, adding that health professionals themselves must undergo specific training to develop this new skill.

Spanish doctor, Emilio Herrera, followed with a study on the costs of treating terminally-ill patients, and highlighted the burden thereof on both health systems and families. The main goal was to describe how one can save millions of Euro and manage financial resources and health better by planning end-of-life care in advance. Ignácio Martin, on the other hand, also analysed the financial aspect of this topic, and introduced specific cases which illustrate the impact of chronic or irreversible disease on household economies.

This symposium also covered the issue of care in neurodegenerative disease. Florence Pasquier, neurologist and professor at Lille University, in France, provided several French examples of how the specific care network is organised at regional level, for both Alzheimer's and young patients.

Manuel Caldas de Almeida also provided a specific example – palliative and dementia care delivered by Espirito Santo Saúde, an integrated and holistic response to the problems of older people and patients with chronic or irreversible diseases.


Special Report, Leaping Forward - Lisbon International Clinical Congress, Hospital da Luz, Lisbon, february, 13-19.