November 17, 2017

In search of a quiet death

The University of Sao Paulo and U-M Division of Geriatric Palliative Medicine have launched a program where Brazilian residents have come to Michigan to learn the basics of palliative medicine

palliative care

Palliative medicine in Brazil still crawls. Many don’t understand its concept of providing care for patients with a life-threatening illness to give them a better quality of life. There are no abusive interventions, but an integrated and customized treatment.

“We look at the patient in a complete, global way and work with his physical, psychosocial and spiritual needs,” explains Marcos Montagnini, M.D., director of the University of Michigan Palliative Medicine Education Program, and a professor of internal medicine in the Medical School.

The palliative professionals work harder for the humanization of medicine in a deeper way, where the doctor-patient relationship goes through a variety of disciplines, exercises and case studies. The services include therapeutic measures for the control of physical symptoms, psychotherapeutic interventions and spiritual support to the patient, from diagnosis to death.

The service also helps the patient’s loved ones, with actions like social and spiritual support and psychotherapeutic interventions from diagnosis to the period of mourning.

“The population is aging and the problem is that there is no room for palliative care in Brazil,” Montagnini says. “It is imperative to align the physical treatment with the emotional side of a patient. It is really an emerging field.”

Only three of the 180 medical schools in Brazil, or 1.7 percent, offer education in palliative medicine.

In order to fill this gap, the Department of Internal Medicine at the University of Sao Paulo (USP) and the UMMS Division of Geriatric Palliative Medicine launched collaborations and a new program. Since 2016, eight Brazilian residents have spent a month in Michigan to learn and experience the basics of palliative medicine.