Palliative Care team makes a difference

Desiree and Owen Ross have been married for 33 years. Their lives were changed overnight when she was diagnosed with liver disease in 2019.

Desiree has advanced liver disease with portal hypertension. As a result, she has lower limb swelling and weakness, which means she has to use a wheelchair in order to be mobile.

“I felt really sad. I thought I was going to die. I had never experienced anything like this before. But I have accepted it. We can’t deny our illnesses, we can only accept them and learn to live with them. I ensure that I take my medication and follow my doctor’s advice,” says Desiree.

The 53-year-old recalls finding out about the illness when she visited the Delft Community Healthcare Centre (Day Hospital). “I found out when I visited the day hospital in Delft. They transferred me to the Eerste River Hospital as soon as they realised I had liver disease. Since then, I have received support from the palliative care team at Delft on my journey.”

Desiree says she never expected to become ill, but support from her husband and the palliative care team got her through. “I have received counselling from the palliative care team and I had received home-based care when I was very sick. The home-based caregivers were like my own children. They helped to bath me, I received meals, and they even offered to help with things around the house. I’d tell them to make tea as well for themselves. They’d say, ‘Aunty Des, is there anything else we can do?’ They’ve really helped me. They still visit and check on me. The people at Delft (Day Hospital) still check on me. This is how you should treat people,” says Desiree.

“And then there’s my husband. His support helps me. We are one. If I am sick, he feels down. When he isn’t well, I don’t feel okay. We protect and care for each other. Despite my illness, he has supported me and he refuses to give up on me,” says Desiree.

Her husband, Owen, wipes away tears as he commends the Delft palliative care team and thanks health workers. “The palliative care service was helpful. I have been there with my wife when this all happened and they were also there to support us.”

Desiree also thanked the team for their support. “The palliative care team has really done amazing work and continues to help and support me and my family. If it had not been for them, I would not be where I am at right now. Their service is excellent. The social worker, Mariam Davids, has always reached out to us. She’s kind and checks up on us regularly.”

Delft CHC’s Dr Sheron Forgus explains when palliative care is appropriate. “Palliative care is holistic, multidisciplinary care for a patient and their caregivers who are experiencing a chronic, debilitating and or terminal illness. It addresses physical symptoms, assists with rehabilitative needs and provides social, spiritual and emotional support. It aims to provide the patient with dignity and improvement in the quality of life.”

The palliative care team at Delft CHC is a multidisciplinary team consisting of nurses, doctors, a dietician, physiotherapist, occupational therapist, social workers and the community-based nurses. “Through the programme, patients that are found in the community with palliative care needs and they are linked to the facility team. The various needs are assessed and addressed, such as pain relief, nutrition and supplements, wheelchairs, mattresses, or wound care. Social support is also offered telephonically. Similarly, patients from the facility are linked to a community-based team who delivers medication, provides wound care, assists with medication, hygiene and provides support,” Dr Forgus explains.

Social worker Mariam Davids says they aim to help patients recover emotionally and physically. “Palliative care allows us to further care for patients after they’re referred from our district hospitals and we can provide support. The assessment involves looking at what they need, from their emotional needs to providing any other support. We’ve got a team that supports not only the patient, but their family as well. We walk this walk with them.”

As the world marked World Hospice and Palliative Care Day on Saturday, 10 October 2020, Juanita Arendse, the director for health services in the Northern Tygerberg Sub-Structure of the Cape Town metro, says Western Cape Government Health is committed to universal healthcare for all and this includes prevention, promotion, curative, rehabilitative and palliative health services.

She cited the World Health Organization (WHO) fact sheet, which states that approximately 40 million people globally are in need of palliative care, of which 78% are in low- and middle-income countries and only 14% of those in need of palliative care currently receive it. “The WHO fact sheet states that ‘palliative care is explicitly recognised under the human right to health’ and this is why it is important that we offer palliative care to all eligible patients,” says Juanita.

Juanita explains that early palliative care can also reduce unnecessary hospital admissions. “In order to address suffering, a team approach is required to support the patients and their caregivers or family with regards to their physical symptoms, practical needs and bereavement counselling. Palliative care also offers the support system that the patient will require in order to live as actively as possible and have quality of life”

She adds that “anyone who is assessed by their clinician to be eligible of receiving palliative care, irrespective of age, will benefit from this service.”

For more information on palliative care, please speak to your healthcare worker at your nearest Western Cape Government Health clinic.