According to the World Health Organization (WHO), palliative care is defined as an approach that improves the quality of life of patients and their families facing the problem associated with a life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

Palliative Care commences from diagnosis or at the initial stages of chronic disease and aims at improving the quality of life of patients, by offering not only pain relief, but also relief from other symptoms. These symptoms may include difficulty breathing, nausea, vomiting, fatigue, weight loss, insomnia, anxiety, and depression.

Psychosocial rehabilitation may play a role in the mental health of patients undergoing palliative care, contributing to the minimization of symptoms, support in daily life activities, and the improvement of quality of life.

Kenya Hospices and Palliative Care Association (KEHPCA) participated actively in the KILELE Health Symposium 2020; a Pan African conversation on cancer survivorship in Africa. The KILELE Health Symposium 2020 addressed the four parameters commonly used to define the quality of life in cancer survivorship: Physical Fitness, Mental Wellbeing, Economic Empowerment, and Finding Purpose; set against a background of COVID-19.

Psychosocial care, as defined by the National Council for Hospice and Specialist Palliative Care Services, is care concerned with the psychological and emotional well-being of the patient and their family/carers, including issues of self-esteem, insight into an adaptation to the illness and its consequences, communication, social functioning, and relationships.

“Many patients and providers hesitate to seek ‘palliative care’ because they mistakenly fear it is akin to giving up on treatment. This is not true. An integrated and comprehensive approach to cancer care should include psychosocial and psychopharmacological interventions.” Dr. Zipporah Ali – Executive Director, KEHPCA.

Physical and mental health are inexorably interwoven, complementing, and affecting each other. A physical disease, be it chronic or not, often affects a patient’s mental health. Similarly, the psychological strain may affect one’s physical health and cause problems. When physical conditions coexist with mental disorders, especially depression, this may impact the progression and prognosis of a disease in various manners.

Cancer is a devastating disease causing significant psychological problems among patients and their families. In the past few decades, there has been growing implementation and dissemination of screening methods for the psychological consequences of cancer, including distress, depression, anxiety, post-traumatic stress, and demoralization. Also, guidelines for the management of psychological distress have been developed and endorsed by a number of scientific cancer associations. Recent advances in psychosocial and psychopharmacological interventions are now a part of a mandatory, integrated, and comprehensive approach to cancer care.

Given the high number of cancer patients surviving their disease, survivorship has recently occupied more attention of both researchers and clinicians interested in psychosocial oncology, with data indicating that the creation and implementation of optimal methods for promoting the health and wellbeing of post-treatment survivors are critical for complete cancer care

KEHPCA exists to promote access to quality palliative care for all in need across Kenya. “Palliative care is a human right. Offering access to palliative care services can help people to remain in the place or community of their choice and where they feel they belong, enhancing their quality of life and preserving their dignity.” Dr. Zipporah Ali – Executive Director, KEHPCA

Psychosocial interventions to be evidence-based and where possible tailored to the needs of the individual cancer survivor.   More efforts should be devoted to disseminating and implementing interventions in practice and to evaluating their cost-effectiveness and greater attention paid to the needs of vulnerable and high-risk populations of survivors, including the socioeconomically disadvantaged and the elderly.

Working with people at the end of life is a privilege. The emphasis is about spending as much time as is required to help people come to terms with their mortality and adapting to many changes. It is about helping everyone involved to live their best possible lives until the person dies and continuing care into bereavement.