According to the World Health Organisation (WHO), 40 million people each year are in need of palliative care, and most of them are from middle and low-income countries. Nonetheless, only about 14% of people are actually receiving palliative care globally.

One of the main aims of palliative care is to treat symptoms, rather than treating the disease itself. One example is the use of opioids in alleviating pain in diseases such as cancer and AIDS.

Nowadays, only 34% of patients receiving palliative care are cancer patients. Others are patients suffering from cardiovascular diseases (38.5%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%).

The history of palliative care

The terms ‘palliative care’ and ‘hospice care’ are often used in the same context. However, by definition, palliative care is more general while hospice care refers to care for a dying patient with no hope of a cure.

Despite that, both terms are interrelated. The idea of hospice care dates back to medieval times, where a hospice was a place that allowed tired or ill travellers embarking on a long journey to rest.

This traditional idea of hospice care was further developed into modern hospice care by Dr. Cicely Saunders. Her idea was introduced in the late 1950s, with the ultimate aim of providing comfort to a dying patient.

She believed that a hospice care team should have multidisciplinary healthcare providers to give support to the dying patient and the family. The idea was introduced in 1963, when she gave a lecture about holistic hospice care in Yale University.

In 1967, she established the first modern hospice, St. Christopher's Hospice in the United Kingdom. This idea of holistic hospice care was widely accepted. It has also become the core of current palliative and hospice care.

Palliative care has been increasingly in demand

Over the past century, palliative care has extended not only to a few particular diseases such as cancer and AIDS, but other life-limiting illnesses as well. This includes cardiovascular diseases, chronic respiratory diseases, and diabetes. Also, it serves not only at the terminal stage of diseases but also at the early stage of diagnosing it.

Improvements in palliative care have been increasingly discussed since it can improve the quality of services, reduce healthcare costs, and improve quality and longevity of life of patients. A 2011 study done in the US found that a patient who received palliative care spends on average USD 6,900 less than a patient who received usual care.

The need for improvements in palliative care

Despite the benefits of palliative care on individual health and economy, only a few countries have a good palliative care system. A study done in 2011 found that only 20 countries out of 234 countries have good palliative care services, while 32% have an isolated service and 42% have no palliative care services at all.

In addition, many countries still lack expertise in this area. For example, in the US, an estimation of 6,000 to 18,000 hospice and palliative care specialists are needed to meet the demand in the country. This number may differ according to country, but without a doubt, it will increase significantly in developing countries. MIMS

Read more:
Palliative care: Why patients deserve the truth
Legalising euthanasia: The ongoing debate between doctors
Singapore's MOH to improve palliative care by increasing inpatient beds