EVERYONE has the ability to communicate with empathy and be involved in palliative care.
A firm believer in this, Dr David Paul Capelle (pic) urged students considering a healthcare career to take on the responsibility of incorporating palliative care into their practice.
“It really encompasses every aspect of healthcare. It helps you see medicine in a broader context and think of it as a humanities subject as well.
“In many ways, writers like Tolstoy – please read The Death of Ivan Ilyich – have been far ahead of modern palliative care as researchers of suffering and quality of life,” he told StarEdu.
A palliative care physician at Universiti Malaya Medical Centre (UMMC), Dr Capelle said he first discovered palliative care as a student.
“I saw a cardiothoracic surgeon perform a long operation on a woman with a severe heart attack, who later passed away in the intensive care unit. I vividly remember the doctors discussing the best way of treating her. It got me thinking about how we should care for patients in modern medicine,” he shared.
In the age of artificial intelligence, Dr Capelle said one way to think about it is that humans must do what these tools can never do: be present as a person.
“There is a misconception that this takes up a lot of time and therefore is difficult in hospitals and busy clinics, but the opposite is true.
“A lot of time is wasted if we neglect emotional and mental distress by focusing only on physical symptoms. We can build on a lot of psychology and spirituality research that has been done in the recent past,” he said.
He also addressed other misconceptions surrounding palliative care.
“Palliative care is often seen as ‘giving up’ or even having ‘nothing more to do’. This is far from true.
“Although invasive or aggressive treatment may no longer be beneficial, there is an important role for palliative care in relieving symptoms based on modern science,” he said.
He added that the term “hospice” is also often misunderstood, “since it has different meanings in different countries”.
“While some countries offer hospice care as an inpatient service in wards or institutions, in Malaysia, hospice care is community-based and mostly funded through philanthropy,” he noted.
Another misconception he finds “very misleading” is that hospice is the same as end-of-life care.
“In fact, hospice care is appropriate for anyone with a life-limiting illness, such as cancer or incurable organ failure.
“Involving hospice early is the key to the best possible quality of life in these situations,” he said.
For patients at the end-of-life stage and their families, Dr Capelle advised having honest conversations with the medical team.
“End-of-life care is ultimately an important part of palliative care, but it is also a comparatively short period of time – days perhaps – which follows a longer stretch of months or years. Deciding to get hospice support involved early on is an important decision for better quality of life.
“Besides this, advance care planning is important. This means thinking about which types of treatment a patient and their family would like to have under different circumstances. For example, it could mean controlling symptoms rather than aggressive treatment in the intensive care unit in the future,” he said.
Dr Capelle also recommended that patients use every opportunity to communicate with their treating doctors.
“Patients need helpful and honest information about their disease to prepare for end of life. Having a good patient-doctor relationship is the key to making shared decisions. I would encourage patients to ask at every stage not only what treatment options are available but also what outcomes could be expected from each of these,” he said.
He also had advice for caregivers supporting their loved ones.
“Communicate at every step, rope in all the support available, and don’t neglect to take care of yourself. Wanting to support a loved one is natural and very rewarding, giving meaning to an otherwise difficult time in life – as long as we do not neglect our own physical and spiritual well-being,” he said.
On what he finds most rewarding about his work, Dr Capelle had this to say: “The term ‘holistic care’ is perhaps overused, but it is very rewarding whenever we are able to improve a burdensome symptom and it leads not only to the patient being comfortable, but also to their being at peace and experiencing joy and connection with loved ones after a time of despair.
“Palliative care, more than other specialties, allows us to focus on the person with the illness.”
Serene, 17, a student in Perak, is a participant of the BRATs Young Journalist Programme run by The Star’s Newspaper-in-Education (Star-NiE) team.
For updates on the BRATs programme, go to facebook.com/niebrats.
Key terms
Palliative care:
- l Relieves suffering from life-limiting illness (such as cancer or heart disease) and improves quality of life in body, mind, spirit and social connection
- l Can be provided in hospital or at home
- l Appropriate whenever there is significant suffering, not only at the end of life
Hospice care:
- l Home-based palliative care delivered by nurses and doctors doing visits
- l Allows patients to die at home without distressing symptoms when hospital admission is unhelpful or stressful
End-of-life care:
- l For those in the final days of life
- l Short but vital part of palliative care
Source: UMMC palliative care physician Dr David Paul Capelle
With the theme of the article in mind, carry out the following English language activities.
1 Talk to a partner for one minute about a recent personal experience. The listener must repeat as many details as possible. Give a “gold star” if they remember small but meaningful details.
2 In pairs, act out a short situation (e.g., comforting a friend, visiting a sick relative) without speaking. Classmates then guess the situation and role-play what could be said.
The Star’s Newspaper-in-Education (Star-NiE) programme promotes English language learning in primary and secondary schools nationwide.
For Star-NiE enquiries, email starnie@thestar.com.my.
