Since the majority of Thai people, especially in the rural area, wish to spend their remaining days with their loved ones at home, our challenge as healthcare professionals is how to comply with this expectation.
There are many challenges waiting for us, such as symptom control, 24-hour consultation, access to emergency care, and carer training.
Thus, this knowledge-sharing workshop, supported by Thai Palliative Care Society (THAPS) and Thai Health Promotion Foundation, had called for those who are working in the field to combine their knowledge in order to have a better understanding of the key successes of palliative home care.
The knowledge-sharing workshop was comprised of two days panel discussion.
From the discussion, key strategies emerged which lead to success palliative home care:
Proper and adequate training for both healthcare professionals and carers
It is evident that those who are working in palliative care need various skills: communication skill, symptoms control, self-care, among others. But we also met the same conclusion that carers, another key person who are taking care of the patients, need training as well. Especially important are specific skills that may be new to them, such as how to prepare diet for a bed-bound patient, or how to prevent pressure sores.
Regular home visits
Regular home visits were needed by the main healthcare team, community nurse, or a volunteer so that we could detect any issues as early as possible.
It is important to emphasise to the family that we are not abandoning them, but rather that home visits let their loved ones live in their most comfortable surroundings.
One of the major challenges in Thailand is limited access to opioid medications due to overly restrictive laws and an opiophobic attitude by healthcare professionals and the public. Some patients even have to travel very far from their home to receive some essential medications because they could not get them from their local hospitals.
The suggestion and practical example we came out so far is to draft a careful tracing protocol to reassure the administrators and pharmacists that these medications won’t be misused. To prescribe these medicines to the patients, we trust them enough that they won’t abuse it. This is very unlikely as no morphine has ever been falsely used before.
Integrated referral system
All of these preparations cannot be effective unless we have a proper network to receive and to care for the patients in the community. Network building and concise referral system to the local hospitals are other key considerations.
Like the previous Pal2Know workshops, the content will be analysed and distributed nationally as a reference handbook in upcoming months.
The next and last knowledge-sharing session, to be held in February, will be about: ‘Bereavement Care’.