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In the wake of the previous report, which dealt with the need to raise public awareness about the treatment of cancer patients and affects the lives of a large part of the Lebanese, after it was revealed about 15 years ago, that Lebanon year after year, there was a significant increase in the number of cancer patients. A report in the sense of "palliative care":
Although healing from cancer is possible, especially when detection is early, the journey of many patients toward healing ends when the disease overrides the patient.
Two main stations print this trip: the first is Diagnosis, informing the patient and his family of the result and receiving treatment. The second step is the decision of the doctor to stop treating the patient and inform the patient and his family. Thus, the cancer patient enters the end of life phase.
Care of life
Here, the role of palliative care closely badociated with the interruption of treatment by the patient is highlighted by the lack of hope of cure. But researchers in the medical and psychological fields are turning to today not to limit palliative care at a specific stage of the patient's life. The World Health Organization has described palliative care as "improving the quality of life of the patient and his family in the face of a chronic and incurable disease". Palliative care means the rest of life, not the end of life.
"Palliative care is not exclusive to patients in their last days, but they should receive it as soon as they are treated," said Professor George Shaheen at the Lady of University Hospital palliative care conference . "The treatment of cancer requires a team consisting of a doctor, a therapist, a nurse, in addition to music therapy or art, and sometimes a spiritual guide if the patient wishes it. " Professor Shaheen shares this view with the results of studies showing that life expectancy is higher in patients who received palliative care early on than in those who did not receive it or who did not receive it. have received late.
In 2014, the World Health Organization (WHO) used the term "palliative care" in 1990. In 2014, he advocated for better access to palliative care as an essential part of health systems. , with a focus on community care services. And cleaning.
The reality of the situation in Lebanon
What is the situation in Lebanon today? Dr. Hamra emphasized that palliative care is about the patient and their family throughout the illness, not just at the end of life. "Palliative care is essential for cancer patients, but not for people living with HIV, but for people living with HIV or other diseases."
Lebanon has the highest average life expectancy in the region at 79.93, of which 10% is over 65 and 1.5% over 85. Cancer cases represent 13,000 new cases per year, while 15,000 patients a year require palliative care. But only 5 to 10% of them have it.
Confidentiality is not a cure
Hamra believes that some of the taboos continue to hinder death in Lebanon, making discussion on the subject rare in the family and with specialists, even with the patient himself in his last days. In this way, family members think they are protecting the patient from the reality of the truth. Only 19% of patients are diagnosed or diagnosed. Thus, decisive decisions concerning the life or death of the patient are taken without consulting him or even informing him about it.
Here is what Dr. Hadi Ghanem described as a bit of humor: "My badistant told me that my patient was a stenic man who was entering my office with a delegation of four women." Know something about the diagnosis. "Ghanem criticizes the fact that doctors comply with the wishes of the family by asking themselves: how can the patient cope with the disease and receive the necessary medical and psychological care, including palliative care?" Ghanem goes further: "The problem is primarily ethical and the patient must know that he has cancer, what treatment, what side effects, and that he is free to accept treatment or rejection, regardless of who the member is. his family.
The experience of "Sanad badociation"
Dr. Hamra thinks that convincing the patient and his family to transfer him from the hospital to the home and to die in his bed safely, surrounded by his loved ones, if possible, is one of the problems the more difficult for workers in the palliative care department.
The Sanad badociation, the first palliative care badociation in Lebanon, has been working since its creation in 2010 to overcome these difficulties. It provides care for the elderly and those with life-threatening illnesses who have no hope of recovery, especially those who have decided with their doctor and their families to spend the rest of their lives at home. The Society strives to provide care to these patients and their families by improving the quality and standard of living and to preserve the dignity of patients and their families by providing comprehensive patient care, including medical, social and community support. psychological home. It has a team specializing in palliative care of doctors, nurses, psychiatrists and others working in the fields of public health, nutrition, social work and spirituality.
Dr. Salam Jalloul, medical director of Sanad, said the organization was treating patients with advanced disease, that is, those who do not have the disease. have only six months or less of life. During the remaining 48 hours of the patient's life, the accompanying medical staff stands beside the patient and his family and informs them of the patient's fate. Whenever possible, the crew tries to create a debate about the end of life, the talk about death being often whispered and hidden behind the walls.
Life before death
Dr. Jalloul points out that palliative care does not mean waiting for death, but on the contrary, that the man is still alive. "Two days before her death, she wanted her daughter to obtain her university degree.It dressed her in a graduation gown and a hat and accompanied her to the ceremony and took pictures of them.The patient, who lived far from his village and his hometown, was able to spend a whole day in the village with his family, pain-free after taking pain medication The patient died a week later.In another case, an honorable patient could have died after visiting St. Charbel Church, as she had wished after three years of imprisonment. In the church, she took pictures and sent them to her family members with the words: I love my life.
"We are doing everything in our power, not only to die in peace, but to live as long as human lives," concluded Dr. Jalloul quoting Cecily Saunders, British doctor and researcher in the field of patient care at the end of life. In conclusion, Dr. Jalloul emphasizes that palliative care does not end with the death of the patient, but rather with the family of the deceased who has entered the mourning phase.
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