Next Steps in Palliative Care Services
Although there are many issues to be addressed at the Federal and State level, CARE Act grantees and service providers can take action to advance palliative care for PLWH/A:
- Adopt an expanded understanding of health planning using the perspective of a “chronic disease” model and devoting some degree of resources for palliative care within the chronic disease model.
- Develop service models that integrate palliative with curative services and develop specific competencies in palliative care programs.
- Expand ADAP formularies to cover important palliative care interventions.
- Train local providers through a palliative care curriculum.
- Include palliative care experts on planning bodies.
- Collect and analyze data (numbers of deaths in recent year, site and cause of death, related conditions, premorbid use of medical or social services) to describe and elucidate the need for palliative care services within the community and to identify issues central to the implementation of those services.
- Develop and test palliative care quality assessment and management programs.
- Collaborate with Federal and State agencies to develop and revise policies that facilitate palliative care.
Instituting palliative care in today’s highly stressed systems will not be easy. Many parties may feel threatened with the loss of resources for services for which they are passionate. Others could be overwhelmed by the very challenging evaluation issues and their resolution. If a broad perspective on health care is taken and a cooperative attitude is adopted, however, palliative care can become part of comprehensive HIV care. Once this is accomplished, the quality of life and well-being of PLWH/A will be greatly enhanced.
