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Palliative Care and the Significance of the
Thomas W Miller*
Professor Emeritus & Senior Research Scientist Institute for Health, Intervention & Policy, University of Connecticut, USA and Department of Gerontology & Psychiatry, University of Kentucky, USA
Submission: July 09, 2020; Published: July 13, 2020
*Corresponding author: Thomas W Miller, Professor Emeritus & Senior Research Scientist Institute for Health, Intervention & Policy, University of Connecticut, USA and Department of Gerontology & Psychiatry, University of Kentucky, USA
How to cite this article: Thomas W Miller. Palliative Care and the Significance of the Safety Signal. Palliat Med Care Int J. 2020; 3(4): 555618.
Advances in palliative medicine and health care has as its focus persons with advanced and progressive disease and their caregivers [1-5]. The goal is to provide a meaningful quality of life by emphasizing care of the whole person, including family, loved ones and those empowered to provide skill and comfort in the face of very serious and challenging health issues. Palliative medicine is often misunderstood because it is often linked to late-stage illness and hospice care and imminent death. The goal is to help individuals feel better and remain active and involved with meaningful activities during medically relevant health related treatment.
It’s not uncommon for a terminally ill loved one to become unusually restless or even agitated, but it is often distressing for family and friends to witness. The depth of such restlessness or agitation varies from patient to patient; in some cases, it can progress to a state known as “terminal restlessness,” or “terminal delirium.” Delirium is a complex psychiatric syndrome, also sometimes referred to as “organic brain syndrome,” “confusion,” “encephalopathy” or “impaired mental status.” It is often recognized by sudden change in the patient’s alertness and behavior. This change can sometimes fluctuate over the course of a day, and may worsen at night. An advanced progressive disease states can result in increased levels of stress, anxiety, panic, adjustment difficulties and levels of functional depression for some individuals (Miller 2015). Recognized is the realization that these unusual circumstances create significant uncertainty and unease in the professional and personal lives of health care professionals and their patients.
Concepts of hope are important ingredients in one’s life especially as they face advanced disease states. Hope in the face of a advanced or terminal illness needs a safety signal for each
patient and their caregivers. From a psychological perspective, a safety signal is a learned cue that predict the nonoccurrence of an aversive event or condition. As such, safety signals are potent inhibitors of anxiety, fear and stress responses. Clinical; Investigators of safety=signal learning have increased over the last few years due in part to the finding that traumatized persons are unable to use safety cues to inhibit fear, making it a clinically relevant phenotype. When first confronted with a terminal illness, most patients typically relate hope to a tangible treatment or option that can provide safety and positive thinking with respect to one’s clinical condition.
As opposed to danger learning where a cue is paired with aversive stimulation, safety learning involves associating distinct environmental stimuli also known as safety signals that can be used and applied when aversive thoughts occur in the patient or caregivers. During periods of high stress such as during periods of depression with advanced or terminal illness, apprehension and fear often permeates the lives of those involved because if the unknown nature of this illness. This occurs because of the absence of a learned safety signal. Such safety signals can reduce or inhibit fear responses to cues in the environment. As such, safety signals are only learned when the subject expects danger but it does not necessarily occur. More fundamental to the clinical importance of a safety signal is the distinction between safe and dangerous circumstances. Thus, identifying the mechanisms of safety learning represents a significant goal for basic neuroscience that should inform future prevention and treatment of trauma and other anxiety disorders Transitioning Terminal Illness.
The urgency has created stressful life experiences for all ages that pose the potential for illness resulting for some in disabling fear, a hallmark of anxiety and stress-related disorders [6-8]. These researchers report on a novel way that could aid in addressing anxiety and depression realized because of serious or terminal illness. When life stress events as terminal disease or
illness trigger excessive fear, the benefits of a safety signal may
relieve some of the apprehension experienced. In humans, a
symbol or a sound that is never associated with adverse events
can relieve anxiety through an entirely different brain network
than that activated by fear and worry. Each individual must find
their own “safety signal” whether that is a mantra, song, a person,
meditation, spiritual or even an item like a stuffed animal that
represents the presence of safety and security .
The safety signal is a key ingredient in palliative care which
is a term derived from Latin word “palliare,” which means “to
cloak.” It refers to the specialized medical care for persons with
serious and/or terminal illnesses. Identifying a safety signal that
is relevant and meaningful for the patient and for family and
caregivers is critical. It is focused on providing every individual
involved with a person facing serious illness with relief from
a spectrum of symptoms, pain and stressor associated with the
illness being faced. Palliative care including a safety signal can
be most beneficial because it can aid individuals in experiencing
a higher quality of life while dealing with serious illness. With
its holistic approach, palliative care can help reduce physical
pain, support mobility and promote positive psychological and
emotional well-being while dealing with illness regardless of the