Palliative Care: Changing Paradigms to Face New Challenges

Abstract

Recent studies conducted in the world’s most industrialized nations reveal that access to palliative care is both inadequate and unequal. The problem is exacerbated by the exponentially growing need for this type of care due to the world’s rapidly aging population. These findings have prompted governments to address the problem, most often with new legislation and the allocation of more resources. Despite these efforts and a definite improvement in access to palliative care, important inadequacies and inequalities in access to these services persist. A paradigm shift in the way palliative care is seen and  implemented, inspired by new research and pioneered by the work of Allan Kellehear, could better serve the world’s aging and vulnerable populations: rather than continue to separate the sick and the dying from their communities in order to treat them in costly, depersonalizing institutions, these patients would become a central component around which community services and professional care services would be organically interwoven. This new model, called the “Compassionate Community” model, is inspired by public health approaches of health promotion.  Initial experimentation with such communities has yielded promising results, suggesting that the Compassionate Communities model could prove to be a viable alternative to the current approach to palliative care and to the overstrained system borne from it.