Comprehensive health service is not only performed in hospitals. It also includes pre-hospital care, the care while in the hospital and after hospitalization. The goal includes aspects of promotion, preventive, curative, and rehabilitative, whose primary goal is to maintain one’s ability to be optimally independent as long as possible. In a case that has been concluded by team of doctors to have small chance of healing or hopeless or also known as terminal-stage patients (PST), of course, it takes a special service. This is where palliative care becomes an important aspect in health treatment, particularly the field of geriatrics (health problems in the elderly).
This is stated by Chairman of Palliative Organization Branch of Yogyakarta, dr. Probosuseno, Sp.PD, K-Ger, FINASIM, in the second Palliative Seminar Palliative Care through Multidisciplinary Approach at the Auditorium of Ismangoen building, Faculty of Medicine, Universitas Gadjah Mada, Saturday (6/7). The event attended by hundreds of participants from Yogyakarta, Bandung, Bali, Semarang, and Surakarta is held by the Nursing Science Study Program.
Probosuseno further said that palliative care is an approach that aims to improve the life quality of patients and their families in facing the problems associated with life-threatening illness, by preventing and relieving the suffering through early identification and assessment as well as treatment and other problems-physical, psychosocial, and spiritual. "Palliative care requires a multidisciplinary team," said a doctor of the Geriatric Medicine Sub-division, Department of Internal Medicine, Faculty of Medicine/SMF Geriatric of Dr. Sardjito General Hospital.
Considering the importance of the palliative care role, Probosuseno hopes that each hospital (e.g. type B hospital) should have some sort of palliative care installation to be used as one condition of hospital accreditation assessment. Meanwhile, in the circle of faculty of medicine, materials related with palliative care is provided for Nursing Academy, Nursing High School, Health Vocational School, psychology, nutrition, and pharmacy. Thus, candidates of civitas hospitalia get early exposure of this palliative care.
Similarly, dr. Ali Agus Fauzi, PGD Pall Med of Development Center of Palliative and Pain-Free Health Care Dr. Soetomo Hospital – Airlangga University Surabaya, describes that palliative care is not only to cure diseases. Not only the patient but also the family is handled. Some possible places to do palliative care are hospital, health center, health shelter (nursing / hospice), and the patient’s home. "In the past, palliative care is given only to patients with medically incurable cancer, but now it is extended to all stages of cancer, even in patients with other life-threatening diseases, such as HIV/AIDS and other chronic disorders," said Agus.
Agus exemplifies the application of palliative care at the Dr. Soetomo Hospital includes outpatient palliative care (polyclinics), hospitalization, home care, day care, and respite care. The organization’s work procedures of the palliative care are coordinative and involve all associated elements by promoting a strong team work, forming an extensive network, high innovation, and wholehearted service.
On the other hand, the lecturer at Nursing Science Study Program, Christantie Effendy, S.Kp., M.Kes., raised the issues of cancer patients in Indonesia and Netherlands. According to Christantie, although Indonesia and Netherlands are very different, cancer patients in both groups have nearly the same physical problem with fatigue and pain in the top of the list.
Of all the problems, unmet needs in Indonesia are higher than those in the Netherlands. For the prevalence of social and psychosocial problems in Indonesia, it is lower compared with the group being researched in the Netherlands. "Differences in culture and health system may also have contributed to this condition," Christantie explained.