In an article in The Conversation , Cristina Monforte Royo (director of the Department of Nursing at UIC Barcelona, member of the research group "Care for people at the end of life" and co-director of the WeCare Chair: Life Care), gives us the keys, which we summarise in the form of a decalogue, of The importance of palliative care, which should be a therapeutic resource of primary necessity:

1. According to the World Health Organization (WHO), palliative care is a model of care for the person with a life-threatening illness and their family, and that improves quality of life. In addition, it alleviates and prevents suffering, thanks to early attention to the multidimensional needs of the person.
2. It is estimated that annually 40 million people need palliative care . However, only 14% of those who need them receive them. In fact, the care of patients with advanced disease is one of the most relevant problems facing our healthcare system today.
3. People diagnosed with a life-threatening illness face major changes. In short, potential sources of discomfort related to physical, emotional, social and spiritual-existential aspects. Aspects that affect the quality of life of the person and family.
4. Palliative care provides comprehensive care based on the needs of people at any stage of their illness.
5. Various studies show the importance and need to integrate palliative care early. In one of them , the hypothesis was that the group of patients who integrated palliative care early improved their quality of life. In addition, they decreased depressive symptoms. Finally, they would require the application of less aggressive measures in their end-of-life stage (greater therapeutic adequacy). The results not only confirmed this hypothesis, but also showed that the palliative care group survived longer ( 11.6 months vs. 8.9 ).
6. To achieve this palliative care, an interdisciplinary team of health professionals trained in the care of these patients is required. In addition, palliative care must be provided in an integrated manner through health systems. Finally, they should focus on the person's needs and preferences, drawing up an individualized plan.
7. There are several studies that analyze the needs of patients in palliative care. His research group has carried out A systematic review of 49 published works on the assessment of the needs of these patients. Among other aspects, it concludes that, in addition to the needs of the physical, psychological, social and spiritual spheres, other different ones emerge. For example, information, security in economic-legal aspects or others related to practical aspects. This is the case of the maintenance and level of autonomy, aspects of changes that occur in the family and social role of people or activities of daily life and decision-making. The palliative care team should assess all needs and make appropriate plans. In relation to decision-making, one aspect that must be faced and agreed with patients is not to initiate or prolong measures that are no longer indicated. In general, palliative care teams address these situations and decisions with masterful precision. They involve the person and achieve consensual decisions, which improve their perception of control. The experience of palliative care teams is key in this integration and adaptation of decisions. The therapeutic tools for patient care and the relief of suffering are multiple throughout the development of the disease.
8. One aspect that raises some controversy in the general population is the use of palliative sedation. This is used as a therapeutic resource when the symptom is refractory. That is, when "despite intense efforts, it cannot be controlled in a reasonable time without compromising the patient's consciousness". Palliative sedation is "the administration of drugs, in the minimum doses and combinations necessary to reduce the consciousness of the patient with advanced or terminal disease". The goal is to relieve refractory symptoms, with your explicit, implicit, or delegated consent. According to the National Hospice and Palliative Care Organization and the European Association for Pallitive Care , Sedation can be continuous, in the event that it is applied in the temporal context of the last days of the patient's life with terminal disease. Of course, as long as the refractoriness of the symptoms indicates it. The indication and use of palliative sedation is done prudently. There is scientific evidence to apply it effectively both in the hospital and at the patient's home, when the necessary resources are available to do so. Sedation is a resource in a specific clinical situation. However, there are many more pharmacological and non-pharmacological treatments available for the relief of the patient's suffering.
9. Palliative care includes bereavement care and family accompaniment. Even after the patient's death, depending on existing resources. This is a very interesting way to close the loop of attending to the needs of the person and their family.
10. Palliative care needs to be fully integrated into all health systems.

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