PALIATIVE CARE: WHEN WE FIND LIFE BY TAKING A GLIMPSE AT DEATH

When a chronic illness follows its inexorable course, leading to physical, emotional, social and spiritual suffering by patient and family, there comes the need for intensive full-time care. Such practice is referred to palliative care and has become ever more prevalent. Aimed at a better quality of life by means of prevention and relief of overall suffering, palliative care requires human and therapeutic resources, aside from a complex multidimensional look . Within this context, we propose to reflect upon the potencial and the challenges of palliative care in the Family Health Strategy (ESF), based on the experience built in the follow-up of two cases in the São Paulo municipal network. The proposal of wholeness of care, geographical-cultural closeness and connection make Primary Care a potencial space to provide end-of-life care in a systemic, autonomous and person-centered way. However, such initiatives are still incipient in Brasil, being limited by the pressure of healthcare, by therapeutic resources and professional development in the area. It is crucial at this point to be able to deal with the subjective dimension of patients, family and professionals, to discuss death and existencial perspectives, requiring professionals to have a distinct behavior. In our service we have instituted the outpatient palliative care practice and the home palliative care practice to clinical and oncology patients, with the involvement of the Family Healthcare Strategy (ESF) team and Family Health Support Nucleus. The limitation of resources is minimized by negotiating with the service, family and community, whereas the multiprofessional work of biopsychosocial-spiritual guidance shows to be a determining factor to achieve quality of life.