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Letters to the Editor
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Palliative care
Pharmacists can be an asset to a local hospice
From Mr N. Baumber, FRPharmS
I was pleased to see palliative care in the community being highlighted
by Clare Amass in her excellent introduction to the Gold Standards Framework
(PJ, 25 March, p353 PDF (50K)).
Community pharmacists can, and do, offer a lot of support to their own
patients who are suffering from incurable illnesses and they can also
be an asset to their local hospice. My own involvement has been with
a hospice charity providing general and supportive palliative care. Our
policy has been to accept patient self-referral and referral from carers
and families, and not just to wait for medical referrals. Even so, I
find that referrals to hospice care are coming later and later and therefore
missing the opportunity for anyone to help except in extremis.
This may be a local failure in communication but part of the problem
is also the tendency for the Government to narrow the definition of palliative
care to the last few weeks of life in order to reduce the budget. For
someone who is diagnosed with breast cancer, who is at first traumatised,
then treated and eventually deemed cured, the process can take up to
six years not six weeks. The public perception of a hospice may be as
unhelpful to the people who need it as the stereotype of dispensing is
when it is misrepresented as the counting of tablets from one box to
another.
Specialist care is an essential pinnacle of hospice care but it is applicable
to a relatively small number of patients. The whole point of the hospice
movement, however, is that support and facilities should be made available
from the earliest moment after diagnosis so that the patient and family
can benefit from the many agencies that are available to help. Respite
beds, day care, hospice at-home services, bereavement counselling and
voluntary help can make a world of difference at the right moment if
a rapport has been established and the psychological barriers removed
by an early introduction.
Depending on what is available in your locality, community pharmacies
could become an ideal location for introductory information, leaflets,
displays and even referral to hospice services if the patient so wishes.
I hope pharmacists will be moved to broaden their knowledge of local
hospice and palliative care services, become involved in fund-raising
or even offer their services as trustees. Their help will always be welcomed
and much appreciated, especially if that interaction results in earlier
referrals.
Noel Baumber
Grantham, Lincolnshire
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The
Pharmaceutical Journal