the development of palliative care and development perspectives of palliative neurology in Tuzla

INTRODUCTION The term «palliative» has its origins in Latin, from the Latin word pallium, meaning robe, cover, veil or coat. And indeed, in the palliative care the symptoms are “hulled”, “covered” with different treatments in order to increase the patient’s comfort or to remove unease, just like a coat shields the body from rain or cold. The word «hospice» is often used in the context of palliative care, and although it is used in several meanings (it sometimes refers to a building – «St. Christopher’s Hospice», sometimes to a group of people – «hospice team», and sometimes to a programme «hospice service»), hospice is first and most the elaboration of a philosophy that can be summarized, according to the Hospice Association of Southern Australia, as follows: «The hospice care accepts death as a normal process and understands it as the last life phase of the dying person, as a special time for integration and conciliation. It furthermore accepts the need of the dying to live a full, proud and comfortable life up to their death, it does not hasten nor defer death. And finally, it secures support to the grieving family and friends.» The term hospice also originates from the Latin word expressing welcome, hospitality to a stranger, the warm feeling between the host and the guest. It is interesting that palliative care and hospice are mostly connected with malignant diseases (in the perception of the general public, of lay persons, of health care workers and also in technical and scientific literature), although many other (non-malignant) internal or neurological diseases can and must be treated with “palliative” and/or “hospice” methods. According to a recent analysis of papers published in three important journals dealing with palliative care (from Great Britain, Canada and the USA), the most common primary interest of authors is the advanced malignant disease. Less than 5% of papers deal with non-cancerous states, mostly with respiratory, cardiac and renal diseases. The only neurological representative is the amyotrophic lateral sclerosis (ALS). On the other hand, the texts and articles published in the neurology field mostly deal with diagnostic procedures and the active treatment of diseases, they rarely include states related to the care of the neurological patient at the end of his life, the effective treatment of symptoms in the advanced stage of the disease. This is a problem in itself in need of a different approach so that neurologists, but also other doctors (e.g. general pracTHE DEVELOPMENT OF PALLIATIVE CARE AND DEVELOPMENT PERSPECTIVES OF PALLIATIVE NEUROLOGY IN TUZLA