Palliative care

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Palliative careHow to start

• ??.??????? ??????????

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Palliative care

• ?????????????
• ???????? ???.
• ???????? Medical oncology training
• ???????????? ????.

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Palliative care

• ???????? Hematology Oncology in the US
• ???????
• Pain control
• End of life care

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Palliative care

• US Hospital
• 2000 658/2489
• 2011 gt 1500 (68)

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Palliative care

• ?????????
• ???????????????????????
• (The worldwide palliative care alliance 2554)

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Palliative care

• ?????
• ??????????????????????????
• ??????? ??? ?????????
• (?????????????????????????????????????????)

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Palliative care

• ??????????????????????????????????????????

???????????????? ????? ??????? ??????
?????????????? 741 438 59
??????????????? 69 49 71
?????????????? 25 18 72
???????????????????? 17 13 76
??????????? 9 8 89
????????????? 21 11 52
?????????????? 93 18 19
??? 975 555 57
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Palliative care

• ????????????????????? palliative care
  ??????????????????????

???????????????? ????? ??????? ??????
?????????????? 439 250 57
??????????????? 49 28 57
?????????????? 17 15 88
???????????????????? 13 12 92
??????????? 8 8 100
????????????? 11 8 73
?????????????? 18 5 28
??? 554 326 59
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Palliative care

• Palliative care unit
• ????????????? ward ????? ?????????????
• ward ????? (?????????? ??? staff ?????)
• 20

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Palliative care

• Hospital support team
• ??????? ?????? ????????????????? ????????
• ????????????? ????????
• 34

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Palliative care

• Hospice
• ????????????????????? ????????????????????????????
  ???? ???????????????????? ???? nursing home
• (?????????? pain, ?????, ?????, ?????????
  ?????????????????)
• ??????? ?????????????????????
• ?????????? bereavement ????

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Palliative care

• Home health service
• 42

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Palliative care

• Out patient clinic
• Palliative care ????????
• ?????????????????? ???? ????????????
• ??????? pain clinic

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Palliative care

• ?????? 25 ??????????? ????????????????????????????
  ???? ???
• ?????????????????????????????????????
• ????????????????????????? 17 ????????

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Palliative care

• ???????????????????????????????? ???
  ???????????????
• ???????????? 1 ????????????? ????? 10
• 1 ??????????? ????? 7

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Palliative care

• ??????????????????????????? palliative care
  ????????????????????????????????
• ??????????????????????????????????????

??????????????? ?????????? ???????????????
??????? ???? ????? ???????????? 20-40 ??.
????????? ???? ???????? ?????? ????????? 60-80 ??.
????????? ???? ???????? ????????? ????????????????? 3-6 ?????
?????? ???????????????????????? ?????????????? ???????????????????????? ??????????????
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Palliative care

• ???????
• ????? ?????? ??????????????????
• ????? Oncologist , Hematologist
• ????????????
• ?????????????????
• ?????????
• Etc.
• ???????????????????
• ???????? Team

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Palliative care

• Training
• ????
• ???????????????
• ????
• ???????????????????????????????????? ???? ????,
  ???????
• ????? (?????????????)
• ?????????????????????????????????

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Palliative care

• Training ??????????
• ????? USA 2 years
• Canada 1 year

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Palliative care

• Training
• ?????????????
• ?????????
• hospice care
• Spiritual care, Psychosocial care
• Bereavement
• Pain management
• Non pain symptoms management
• ?????????????
• ??????????
• ????????

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Palliative care

• ?????????????????????????????
• ???????
• ????
• ?????
• ??????
• ??????????????????????????????

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Palliative care

• ?????????????? (?????????????)
• ????? (?????)
• ??????????
• ????????????????????
• ??????????????????????????????????
• ????.
• ????????

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Palliative care

• ???????
• ??????????
• ????? (????????), ?????? , ????????????????? ,
  ???????????
• ????????????????
• ???????????? 1 ??
• ?????? 2 ??
• ?????????????????? 1 ??

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Palliative care

• (???)
• ???????????????? ???? 6 ?????
• ??? palliative care day

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Palliative care

• ?????????? ?????????
• ?? clinic
• ????????? (??????)
• ????????? ?????? palliative care ??? 2 ?????
• ?? Home health care
• ??????????????????????????

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Palliative care

• How to start
• ???????????????
• ?? Team (?????, ??????, ?????????????????,
  ???????, ???????????, etc.
• ??? (????????, ???????????, ??????????
• ????????? (? ????????????????????????????)
• ????????????
• ????????????????????? ???
• Pain
• End of life care
• ???????????????????

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Palliative care

• (????????)
• ????????????????????????? palliative care mind