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2.The continuum of care-the role of home care in a palliative care service

Rosalie Shaw, M.D. (Singapore)

 

THE CONTINUUM OF CARE -
THE ROLE OF HOME CARE IN A PALLIATIVE CARE SERVICE
Dr Rosalie Shaw
The World Health Organization has defined palliative care as the active total care of patients whose disease is not responsive to curative treatment (1) and has said that every patient with advanced progressive disease has a right to good palliative care.
THE PERSON WITH ADVANCED PROGRESSIVE DISEASE
Let us first consider what happens to a person whose disease is not responsive to curative treatment. There is a time of investigation until the diagnosis is made of a serious disease such as cancer. There is treatment. This may include surgery, radiotherapy, chemotherapy. The person may spend time in hospital during the treatment but soon he or she will be discharged home. There will usually be regular outpatient appointments with specialist doctors and perhaps with the general practitioner. There may be a period of recovery and hope that the disease has been cured. Unfortunately for some, this period of recovery lasts only a short time before symptoms reappear and investigations show that the cancer has recurred.
From now until the time of death, the patient may spend time in hospital or, in some cases, time in an inpatient hospice. However, most of the time will be spent at home. As the disease progresses, the person may have symptoms

 

 

 

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