World Health Day: Palliative Care Around the Globe

As the world’s population continues to climb and new challenges like COVID-19 arise, the demand for high-quality care provided by the hospice and palliative care industry is increasing. Since 2018, an estimated 40 million people around the world are in need of end-of-life care each year, according to a study by the World Health Organization (WHO). 

While a handful of the wealthiest countries in the world are able provide comprehensive healthcare models to their citizens, most are struggling to keep up with the demands of our global population. Sadly, only about 14% of those 40 million individuals will receive the care that they need.

“The thinking that we have the ability to meet the demands of the high-need individuals is a fallacy because we don’t,” says Dr. Timothy Ihrig, Chief Medical Officer for Crossroads Hospice & Palliative Care. “The way we take care of them now is atrocious.”

So in order to elevate and expand how most countries care for their countrymen, including here in the United States, Dr. Ihrig believes providers and doctors should begin embracing a more integrated and holistic approach – wherever they are in the world.

“It’s really by being truthful and engaging and asking what’s important to people,” he says. 

Which countries are leading the way?

The quality of care a patient receives is typically contingent upon where they live. In general terms, wealthier, more industrialized nations are able to provide the highest levels of care to the largest margins of their populations. 

This can be seen in places like Australia, the United Kingdom, Canada and India, says Dr. Ihrig, where the palliative and hospice movements have become widely accepted and utilized by the public. This is due in large part to governmental legislation and national policies that help subsidize the care and promote more productive conversations between doctors and patients. Here in the United States, healthcare policies have not always similarly aligned with the clinical reality of patients facing end of life on an individual level.

It is important that patients are not seen as part of an economic model. In countries where hospice and palliative is being better utilized, doctors and practitioners develop treatment plans with the patient’s best interests at heart, giving consideration to emotional, spiritual, and logistical needs.

“Most countries who have a palliative program or palliative care integrated into their health systems, regardless of the economics of those countries, it’s much more advanced, holistic, and patient-centered,” says Dr. Ihrig, who has experience working in hospitals in these countries. 

Because of these approaches, the public’s understanding of end-of-life care has improved, and overall patient satisfaction has increased.

That’s not to say their systems and models are without flaws, Dr. Ihrig says. There is still tension between providers and specialists and not every patient receives perfect care. But the industry as a whole is not portrayed as it is in the United States, where it’s often synonymous with negative ideas like, “giving up, not fighting, dying, and death,” he says.

The United States and Its Moment of Truth

While the United States has the most expensive healthcare system in the world, it remains one of the most underperforming systems when compared to its peers, according to a study by the Commonwealth Fund.

“What puts those programs and those countries ahead of us is an acknowledgment of life’s reality,” Dr. Ihrig believes. “Meaning, everybody is going to die.”

According to Dr. Ihrig, when patients and doctors fail to acknowledge that death is an imminent reality, they don’t have the proper language or vernacular when addressing their end-of-life circumstances.

With this line of thinking, doctors in the US may prolong a patient’s life, but sometimes it happens at all costs. This generally leads to an escalation of care where procedures and treatments are being done to a patient, regardless of their needs and desires.  

“Palliative care in this country is really constrained by economic models because the system is based on ‘fee for service’,” says Dr. Ihrig, who believes that US doctors often fail to listen, viewing patients as a number rather than a person. 

“What’s really negated is the human being in that journey in this country,” says Dr. Ihrig. “That’s one of the striking differences I’ve experienced working with providers from around the world.”

There is hope on the horizon, however. In recent years, Dr. Ihrig has seen many industry leaders make tremendous strides in advocating for more integration of traditional hospice and palliative methods into the US healthcare system. Hopefully this is a trend that will continue in the United States. 

“There’d be better outcomes and people actually would live longer,” says Dr. Ihrig. “That’s how we can elevate the narrative in our country.”

Providing Care in Non-Traditional Spaces

In many countries around the world, cultural and spiritual barriers may keep patients from achieving peace and comfort during their healthcare journeys. Sometimes it may even be taboo to accept help from a professional or even talk to the doctor directly.

In China, for example, many citizens believe that talking about a terminal illness or diagnosis will bring shame to their family.  Doctors and nurses may have a difficult time navigating these cultural obstacles, but there are still ways to show up and provide quality service in non-traditional ways. 

“One of the fundamental tenets of palliative care is to meet every individual where they’re at,” says Dr. Ihrig. 

By embracing that perspective, he says, any doctor or nurse can “honor the individual.” Sitting with the family or the patient and respecting their boundaries are simple ways to provide care as they acknowledge what is happening in their life journey.  

“It is my belief, whether you talk about it or not, people know. People know that they’re dying,” he says. “So rather than shying away from, let’s recognize it as an absolute.” 

While death may be an absolute, doctors and caregivers should be asking their patients how they want to live, not die, says Dr. Ihrig. This shift in perspective will help frame end-of-life care in a more optimistic light. 

“No patient has ever had the goal of dying.  When we ask about living, we change the healthcare narrative and empower people to live, love, learn, and grow with every breath they have.”

Above all else, no matter where a patient lives in the world and no matter what type of healthcare model their country uses, everyone deserves the truth and to be supported on their end-of-life journey.

To learn more about how we support patients on their end-of-life journey, visit the Crossroads website or call us at 1-888-564-3405.

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