7^th World congress on Hospice and Palliative care November 23-24, 2020 Brussels, Belgium

Palliative care in non-malignant Disease is very important and the existing care method has to update. The palliative care must be based on need, not diagnosis, and the physical and psychological needs of patients with advanced non-malignant disease differ little from those of patients with cancer. The diseases Like Chronic Heart failure, Chronic Lung disease , End Stage renal disease need complex specialist  rather than specific diagnoses, the prospect becomes less daunting. Even if there is insufficient capacity for specialist palliative care services to support all patients with non-malignant diseases, care could be improved by the dissemination of expertise and knowledge.

Clinical ethics is a practical discipline that provides a structured approach for identifying, analyzing, and resolving ethical issues in medical care . Health Professional has to follow some ethical issues in the palliative care like issues related to autonomy, decision-making, whether to withhold or withdraw treatment, nutrition and hydration. According to Belmont report the principles of ethical issues are

·         Respect for persons (autonomy)

·         Beneficence

·         Justice. 

So the Nurses working within a specific dominant culture and tradition need to respect the dominant tradition of the institution where they practice at the same time negotiating between ethical systems to meet the goals of the patient

Some   of the serious Diseases may require special care.  Due to the complex care needs of patients with advanced life-limiting illness it is our experience that a multidisciplinary approach to care can optimize the patient and family illness experience for this vulnerable population. As the illness progresses and care needs become increasingly complex, achieving high-quality whole-person care often necessitates care in multiple settings like inpatient hospitalization, outpatient clinic, and home-based care. Early identification and involvement with palliative care provides multidisciplinary resource for advanced care planning, supportive care, and expert level symptom management. Collaboration between patient/family, oncology providers, and palliative care can occur concurrently with medical treatments, providing for a team-based approach to advanced malignancies, focused on patient-centered care and quality of life.

Aged care refers to the additional care required for an older person needing regular health professional input either in the aged care home. Palliative care is according to WHO Organization an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention. It is important that older people are supported to receive high quality palliative care in the setting of their choice, whether that be in their own home or in a residential aged care facility. Availability of high quality palliative care in aged care facilities and people’s own homes will enable older to have a good death.

Palliative care is a very important to older person at the end of their life that’s the good death. The survey gives result that the rural area has less  palliative care facility compare to the urban area. The palliative care has to improve in the rural area also and the people has to understand the importance of palliative care and the required information has to give for the rural person about the disease so that they can take palliative care. Services less available in rural area that may contribute to the lower proportion of home deaths in rural areas include the lower availability of home-based services, the lack of 24-hour care, and delays in service provision.

Pediatrics and children care is logical treatment of child illnesses. The investigations of kid care with explicit consideration regarding the effect of age at section and sum, quality, and sort of care on kids' versatile working. Pediatric nurture has duties to giving nursing care in emergency clinic, home, clinical, school where kids needs Counseling for the specific disease. The child requires both caring and curing where the caring is constant procedure in both disease and wellbeing and curing   allude to diagnosis and the management

Chronic illnesses are marked by fluctuations and variations over time. Individuals with chronic illness experience pain and other symptoms that are not always adequately managed. Their caregivers often must deal with enormous burden as the illness progresses. Palliative care can serve as an intervention to manage chronic illness, not just at the end of life but also in the early phases of illness.The Primary treatment needs the urgent attention and Secondary outcomes will include health-related quality of life, care giver burden, quality of care and cost-effectiveness of interventions.

Assisted Dying is process in which the patient wants to die by himself but the palliative care makes him strong with proper medical care. Palliative care seeks to identify and alleviate suffering across the trajectory of a life-threatening illness, including care at the end of life, and supports good death while dying. It is evident that doctors cannot decide in a paternalistic way how a disease should be treated and that patients should be inform about the severity of the disease, its impact on quality of life, life expectancy, the options to cure or slow down the disease, and all the possibilities of supportive care.

Geriatric medicine is the medical specialty focusing on the medical care of elderly persons. It was developed as a response to the growing elderly patient population. It focuses on the prevention, assessment and management of their specific health problems across the disease trajectories and includes the physical, mental, social and spiritual dimension. Geriatric medicines focus on the unique need of the elderly person. The physical changes occurred in the elder person like fast change in mental status, acute pain, uncertain symptoms, decrease of wellbeing, Dehydration, Anorexia strange medical reactions. Geriatric palliative care provides comprehensive care for older patients entering to the later stage of their lives.

Palliative care can address a broad range of issues, integrating an individual’s specific needs into care. The physical and emotional effects of cancer and its treatment may be very different from person to person. For example, differences in age, cultural background, or support systems may result in very different palliative care needs.Health Professionals treatments incorporate are intended to re-establish the body/mind balance and incorporate things like aromatherapy, guided relaxation and imagery, music therapy, and therapeutic touch. They are thought to have a positive outcome with regards to helping the patient fall asleep, facilitating muscle pressure, improving the impact of pain medication, upgrading rest, and relieving anxiety

Palliative care is a special type of medical care that focuses on treatment of symptoms people may have when they are living with a chronic (longstanding) illness, such as cancer or heart failure. It is often compared to the hospice care that is offered to terminally ill people. In palliative care, the goal is to provide the best quality of life possible even if someone is not terminally ill.Palliative care can be given when a person is assimilating treatment for a disease and when there is no useful treatment for the disease. However the majority of patients with cancer have pain, proper use of opioids and adjuvant drugs can provide adequate relief in most cases

Oncology deals to the patient of cancer for medically treatment. The patients suffered so much by the medical treatment from side effects and emotional issues. Palliative care provides professional treatment and provide the treatment against the symptoms, their side effects, and emotional problems. Palliative care pushes upward to provide mentally fit.Cancer symptoms may incorporate pain, sickness, vomiting, fatigue, depression, constipation, diarrhea, confusion or shortness of breath. Palliative Care authorities are expertise to interpret the complex medical statistics and can enable you to understand for this They need Better prevention from the palliative care.

‘’Nursing is primarily assisting the individual in the performance of those activities contributing to health and its recovery, or to a peaceful death’’ Virginia’s definition of Nursing. The role of Nursing in palliative care is to provide relief for physical symptoms, achieving quality of life, maintaining an independent patient, relief for mental anguish and social isolation, family support, reducing isolation, fear and anxiety and good death or dying well.

Emergency medicine has progressively taken a central role in the early execution of palliative care. Patients with a serious disease are likely to find themselves in an emergency section at some point along their course of illness, and they should expect to receive high-quality palliative care in that setting. Common integration of palliative care into the day-to-day practice of emergency medicine, however, is often exposed by the demands of many competing priorities.

Spiritual care is an essential domain of palliative care, which focuses on the needs of the whole person and their family. Spirituality is a fundamental element of human experience. It includes the character’s search for meaning and determination in life and the experience of the superior. For some people spirituality can be largely faith based, for others it may be their relationship with nature or the profound connections they have with their people. Spirituality may or may not involve devout opinions.

Occupational therapy practitioners play an important role on palliative and hospice care teams by identifying life roles and activities (“occupations”) that are meaningful to patients and addressing barriers to performing these activities. Unlike other health care providers, they consider both the physical and psychosocial/ behavioral health needs of the patient, focusing on what is most important to him or her to accomplish, the available resources and support systems, and the environments in which the patients want and can participate.

Palliative care and Rehabilitation medicine share the most common goals. They strive to maximize physical function and emotional well-being to the highest extent possible given the nature of the underlying disease process. Many patients with End-Stage disease experience symptoms and functional losses that diminish their quality of life. Rehabilitation and palliative care have emerged as two important parts of comprehensive medical care for patients with advanced disease. clinical experts suggests that the application of the fundamental principles of rehabilitation medicine is likely to improve their care. Physical function and independence should be maintained as long as possible to improve patients' quality of life and reduce the burden of care for the caregivers.

Geriatrics is a specialty that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician or geriatric physician, a physician who specializes in the care of elderly people. Rather, this decision is determined by the individual patient's needs, and the availability of a specialist. Geriatrics differs from standard adult medicine because it focuses on the unique needs of the elderly person. The aged body is different physiologically from the younger adult body, and during old age, the decline of various organ systems becomes manifest. Previous health issues and lifestyle choices produce a different constellation of diseases and symptoms in different people.

Palliative care that improves the quality of life and quality of care for patients with life threatening or life-limiting sickness and their families through the prevention and relief of suffering, communication about goals of care, and early identification and assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

End-of-life care is care taking place in the last part of a patient’s life, typically in the last few months, depending on the primary diagnosis and clinical course and includes planning for end-of-life care.

Palliative care Education is very important to improve the knowledge and skills in the caring of the person. Palliative education required for the nurses, physicians, and other disciplines associated with clinical care. End-of-Life Nursing Education Consortium (ELNEC) is Education institution train-the-trainer approach to provide undergraduate and graduate nursing faculty, nursing Continuing Education faculty, staff development educators, staff nurse, specialty nurses in pediatrics, oncology, critical care and geriatrics, and other nurses with education in palliative and end-of-life care