Unmet palliative care need

The Global Atlas of Palliative Care at the End of Life is reportedly the first document to map the need for, and availability of, palliative care globally, and it presents some stark realities for the Western Pacific region.

It is estimated that every year more than 20 million patients need palliative care at the end of life. This rises to at least 40 million if those who could benefit from palliative care at an earlier stage of their diagnosis are included and if family members are also taken into consideration, the actual need could double or triple.

The Atlas also shows that the West Pacific Region has the highest distribution of adults needing palliative care compared to all other WHO regions (29%).

Dr Yvonne Luxford, Palliative Care Australia (PCA) chief executive, said: “Particularly relevant for Australia is the fact that 69% of people who require palliative care are over 60 years old. This demand is only going to grow as our population ages, and is further evidence for the need to improve palliative and end of life care services in aged care – something PCA has highlighted for a number of years.”

Dr Oleg Chestnov, the WHO assistant director general for non-communicable diseases and mental health, said about one third of those needing palliative care suffer from cancer, but the greatest need is for those with progressive chronic illnesses.

“The Atlas shows that the great majority of the global need of end of life care is associated with non-communicable diseases such as cancer, heart disease, stroke and lung diseases. While we strengthen efforts to reduce the burden of the biggest killers in the world today, we must also alleviate the suffering of those with progressive illness who do not respond to curative treatment,” Dr Chestnov said.

The Atlas calls on all countries to include palliative care as an essential component to every modern healthcare system. This means addressing barriers such as:

• lack of policies recognising palliative care and the need for care both at the end of life and during progressive illnesses;

• lack of resources to implement services, including access to essential medicines, especially pain relievers; and

• lack of education for health care professionals and members of the public about the benefits of palliative care.

“Without supporting the specialist and generalist workforce to provide palliative care across all settings, the needs of dying Australians will continue to go unmet. The development of a Palliative Care Workforce Strategy should be a priority,” Dr Luxford said.

“What I also think we need to look at is the social reluctance to talk about death and dying. The Atlas identifies this as a major barrier to accessing palliative care services, and we know that Australians just aren’t comfortable talking about end of life issues.

“The evidence is clear: palliative care makes a huge difference to the quality of life of those living with life limiting illnesses and services can be implemented at low cost, actually saving health budgets money.”