We need to rethink palliative medicine

Palliative care must be provided to patients with neurological disorders just as naturally as it is offered to cancer patients, according to neurologist.

We are becoming increasingly older, and as a result, the number of people with neurological diseases who need palliative care will soon triple.

Illustrative photo: Colourbox.com  

The longer we live, the more of us there are with Parkinson's, Alzheimer's and strokes. These and other neurological disorders will become new prevalent diseases.

The prognosis is dramatic: In a few decades' time, nursing homes will have to care for over twice as many sick and helpless Norwegians as they do today.

Not just cancer

The health sector must therefore rethink its position on palliative care, a field that has traditionally been targeted towards cancer. Now it's time to include neurological patients, according to neurologist Morten Horn.

"Neurology is The New Frontier for palliative care," he says.

Horn is the clinical consultant at Oslo University Hospital and a PhD candidate at the Institute of Clinical Medicine.

The medical term palliative care is used to describe treatments for relieving and preventing the suffering of patients. At the moment he is lecturing on palliative care for non-cancer patients at a national conference in Oslo.

Horn's message is clear: Neurological disorders should be an equally natural part of palliative medicine as cancer is.

Neurology has undergone a therapeutic revolution. But there isn't a cure for everything. That is why the clinical consultant is concerned about those who have been dealt the worst cards; those who have an illness that can't be treated. It's about providing relief and safeguarding a good death.

A formula that works

"The oncologists have done a good job within palliative care; they have found a formula that works. Now the formula must be shared," says Horn.

Neurologist Morten HornNeurologis Morten Horn thinks that palliative care must also encompass neurological diseases to a much greater extent.

Photo: Ram Gupta, OUS.

Lars Jacob Stovner, Professor of Neurology at NTNU, confirms that neurological disorders will be a substantial health problem in coming years. In answer to the question of whether he considers that these will become common diseases in the future, he replies that it's already occurred.

Professor Espen Dietrichs, Neurologist at Oslo University Hospital, agrees with Horn that neurological diseases will require substantial resources in the future.

"Chronic neurological diseases amongst older people will become an increasingly significant social problem. Thus, the need for palliative forms of care will also grow".

Over half of the budget

Figures from 2010 show that the annual costs associated with diseases of the brain in Norway amount to about NOK 80 billion, according to one report. The expression "diseases of the brain" in the report covers both neurological and psychiatric disorders. The figure includes direct medical costs and indirect costs, such as sickness absence.

In comparison, the total budget for the Ministry of Health and Care Services this year is NOK 139.2 billion.

Are Brean, clinical consultant at Oslo University Hospital and chair of the Norwegian Neurological Association, fills out the picture.

"Diseases of the brain are the most important cause of disability. This fact has not been sufficiently communicated in public debate. People quite simply don't know about this," he says.

The New Frontier

But if neurology is actually to become the new major field of research within palliative care, the neurologists must also possess in-depth knowledge of the area.

Professor at UiO, Nina Aas is Head of the Section for palliative care at Oslo University Hospital. She throws the ball back to the neurologists and challenges them to educate themselves in palliative care.

And Horn catches the ball. He's also very happy to pass it on to his colleagues in neurology. It's the only way that his field can become The New Frontier.

Sources:
http://www.ncbi.nlm.nih.gov/pubmed/21924589
http://www.ncbi.nlm.nih.gov/pubmed/20586727
http://tidsskriftet.no/article/1993496

By Marianne Baksjøberg
Published Sep. 25, 2012 1:10 PM - Last modified Oct. 1, 2012 12:17 PM