Palliative care aims to achieve the best quality of life for patients (and their families) suffering from life-threatening and incurable illness, including HIV/AIDS. Crucial elements are the relief of all pain-physical, psychological, spiritual and social and enabling and supporting caregivers to work through their own emotions and grief.
Palliative care has relieved the intense, broad suffering of people living with HIV/AIDS but the latter brings a number of challenges to its philosophy and practice including:
The complex disease process with its unpredictable course and wide range of complications, which means that palliative care has to balance acute treatment with the control of chronic symptoms;
• Complex treatments which can overstretch health services;
• The stigmatization and discrimination faced by most people living with HIV/AIDS;
• Complex family issues, such as infection of both partners;
• Role reversal in families, such as young children looking after their parents;
• Burdens on health care workers.
A wide range of palliative care is needed for people living with HIV/AIDS, including:
• Pain relief;
• Treatment of other symptoms such as nausea, weakness and fatigue;
• Psychological support for psychological problems;
• Spiritual support and help with preparation for death;
• Support for families and carers-help with nursing, infection control and psychological support.
To ensure that effective palliative care is provided for all people living with HIV/AIDS, governments must tackle the misconceptions that palliative care is only for people approaching death. They also need to:
• improve the training of health and community workers, and general health education, including tackling stigmatization;
• make good palliative care widely available in hospital, hospices and in the community for people living at home;
• provide access to the necessary drugs;
• provide support for carers, counsellors and health care workers;
• recognize the special needs of children.