Palliative care in Kenya needs attention

Categories: Opinion.

There is a lot of confusion about the terms ‘hospice’ and ‘palliative’ care.

It is important to note that hospice is the principle that drives the provision of the service called palliative care.

Most service providers in the world, including those in Kenya, use the word ‘hospice’ in their titles. Others use the term palliative care units/ services/ teams. It does not matter what the title says; they provide similar services and have the same focus.

In some Western countries, palliative care and hospice terms are used to define specific stages of life-limiting illnesses for the sake of payment support.

Many have argued that palliative care has been the missing arm of medicine, that if we cannot prevent it, we should try as much as possible to cure it. But what happens if we cannot cure it?

The World Health Organisation (WHO) defines palliative care as an approach that improves the quality of life of patients and their families facing problems associated with life-limiting illnesses through the prevention and relief of suffering by early identification and impeccable assessment, and treatment of pain and other physical, psycho-social and spiritual problems.

Therefore, palliative care is not about the dying or those on the verge of death. Rather, it is holistic care for those facing the challenge of a serious illness that threatens the quality of their lives, their ability to perform day-to-day activities, social relations and spiritual wellbeing.

Palliative care fills this gap by dealing with the distress of patients and families


The focus of palliative care is the patient and their family.

It is active care geared towards reducing the burden of an illness, relieving suffering, and maintaining the quality of life from the time the diagnosis is made.

Life-limiting illnesses include cancer, heart disease, respiratory disease, kidney failure, HIV/Aids, dementia and stroke, all of which lead to a decline in a patient’s quality of life.

It is notable that as non-communicable diseases such as those mentioned above increase, so does the need and demand for relieving the suffering they cause.

Consequently, patients are now not described as suffering from a terminal illness or being terminally ill, instead, they are said to be suffering from life-limiting illnesses.

The basis of palliative care is symptom management and supportive care.

As a result, palliative care helps patients carry on with life, improves their ability to go through medical treatment, helps them and their families better understand the condition and also assists in the choice of medical care. In short, patients who access palliative care early can expect the best quality of life in their circumstances.

Palliative care reduces the burden on health care providers of making difficult decisions as an illness progresses. Indeed, it has been shown to be a way of preventing stress and burn-out among health care workers.

Remarkably, studies have shown that patients who access palliative care early during their illnesses live longer than those who don’t, with one study concluding that beneficiaries of palliative care outlive those who do not get such care by two months.

For palliative care to be available and accessible, policies need to be made regarding its development availability, accessibility, affordability and understanding of essential drugs, including opioids (pain relievers).

Fortunately, Kenya is on the right track in this regard, but a lot remains to be done. The public also needs to be aware of the importance and availability of palliative services.

We all need to work together towards achieving this goal since we would all want the best for our families and ourselves when we face this challenge sooner or later, when a family member, friend or neighbour is affected by a life-limiting illness.

We need to wake up to the fact that, even though we have powerful medicines and other treatments, we still have one medicine that we don’t utilise often enough, and that is genuine caring and support for someone in distress.

We can no longer have an uncaring attitude until we are personally affected.

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