NEW SERIES: HOSPICE AND PALLIATIVE CARE IN EASTERN AND CENTRAL EUROPE …
Irena Laska, Executive Director, “Mary Potter” Palliative Care Centre, Korça, and national palliative care trainer in Albania, launches our new series and puts the spotlight on Albania.
The “Mary Potter” Palliative Care Centre offers hospice inpatient care, home care and education. It is also involved in lobbying and advocacy, fundraising and raising awareness to further develop this service in our country. Providing palliative care has been a challenge for the staff. Doctors and nurses were initially unfamiliar with the term ‘palliative care’, describing services for this category of patients as ‘worthless’. We can all provide palliative care, but the quality and standards of our services must become standardized for all people in need. This post explains our efforts to do this, both locally and nationally.
One of our greatest achievements to improve quality and standards is the Transformational Leadership training programme. After an initial training course in Brasov, Romania, we later implemented a similar programme in Albania. Thirty individuals applied for this program and 15 were selected to participate. For all participants, the training has provided a new and extraordinary experience. For many, it was the first time they had worked with a project proposal and this has helped them to understand their significance in developing palliative care in their respective regions.
How we began …
“Mary Potter” has offered services for the terminally ill since 1993 when a group of Catholic missionaries from the Little Company of Mary in London established the centre. In 2004, the missionaries transferred the management of the palliative care centre to Albanian staff while continuing to provide financial support. Initially, we provided only a homecare service but nursing staff soon began to develop education and training in palliative care.
Education and training are crucial …
Thus, training was adapted to include assessment and treatment of pain, the use of opiates, as well as treatment of symptoms common to terminally ill patients. Doctors, and nurses took part in training courses, contributing to an improved understanding of palliative care among healthcare professionals. But despite our efforts, only a minority of local healthcare providers were knowledgeable about palliative care, leaving many patients and their families continuing to suffer. To increase knowledge more widely among health professionals, we sought collaboration with the Ministry of Health. This led to the creation of a memorandum between the “Mary Potter” Centre and the ministry, making training compulsory for all health professionals. Following accreditation from the National Accreditation Center for palliative care training, the number of motivated participants has further increased.
The training programmes were of high quality. The key message conveyed at the training is: ‘We provide palliative care, but quality and standards of this service should change and be the same for all people in need.’ As part of the training, participants have created groups of volunteers to begin offering palliative care; others have joined palliative care units in regional hospitals. We have also offered them workplace training.
As a national trainer in palliative care, I had observed that it was the nurses who maintained the closest relationship with patients. Therefore, in collaboration with other colleagues, I identified lecturers within the Nursing Departments to help begin integrating palliative care into standard curricula within these departments.
In the beginning, only foreign-language literature was available and lecturers had little or no experience with the sick to understand their individual needs. What developed was a five-day residential training course for lecturers that included lectures, practical experience and course materials in the Albanian language and allowed participants to share experiences of teaching palliative care during the academic year.
While education in palliative care was growing, the use of morphine for pain treatment continued to be a taboo among many healthcare staff. Many thought the drug should be given only in the last stages of disease so as not to create dependency; believing its use could lead to fatal side effects. Training development and reducing the taboos around palliative care have been essential to reducing the suffering of terminally ill patients and their families. “Mary Potter” staff have successfully shared their philosophy with 1,340 healthcare professionals across Albania, leading to the creation of palliative care centers and increased access to services across our country. But there is still much work ahead. Continuing education and training to prepare the leaders and empower them to make the difference in offering palliative care with standards and of high quality for everyone – this is the future challenge for “Mary Potter” staff.
We envision carrying on the mission of the founding missionaries by ensuring dignity at the end of life by providing patients and their families with high-quality and compassionate services for many years to come.
- Contact Irena Laska by email.
- Korça Palliative Care Facebook page.
- You can read earlier posts about palliative care in Albania here.
Read more posts about Palliative Care in Eastern and Central Europe – next week Alexander Wolf will be writing about developments in Ukraine . . .