ABSTRACT

Background: The English-speaking Caribbean (ESC) region is experiencing an epidemic of chronic communicable and non-communicable diseases that increases the likelihood of morbidity and mortality-related outcomes, resulting in lower life expectancies for both young and old individuals. In resource-poor ESC countries, economically challenged patients have inadequate access to analgesic drugs and experience unnecessarily painful deaths. This paper addresses theory and research on the assumptions and benefits of high-quality palliative care.

Objectives: This paper reviews the evidence regarding the difficulties encountered by patients and their relatives when dealing with chronic and terminal illnesses. These include the inadequacies of the public and private hospitals throughout the ESC countries, and the high financial cost to patients and their relatives in accessing medical care.

Results: The possible barriers accounting for the underdevelopment of palliative care in this region are discussed. They include cultural beliefs on the etiology of diseases, pain management, and on herbal treatment of chronic and terminal diseases, restrictive regulatory drug statutes, and the dearth of specialized palliative care providers in ESC countries.

Conclusion: This paper offers recommendations for the development of sustainable, efficient, high-quality, and culturally relevant palliative care services throughout the ESC region. National guidelines and policies are needed on standards of care, and on pain assessment and symptom and pain management. Well-trained palliative community health workers and volunteers are recommended. The need for ESC governments to prioritize the delivery of palliative care by integrating palliative care and hospice care services with national public health systems is addressed.