Putting the patient before the disease

Irene Higginson is Professor of Palliative Care and Policy at King’s College London, and Director of the Cicely Saunders Institute, the first purpose built institute for research into palliative care.

People with advanced illness often have a dozen or more different symptoms at the same time – from depression, pain and nausea, to breathlessness or a cough. My work examines the myriad of symptoms and problems people face, and how to treat and support them and their family better.

The NHS faces unprecedented pressure. People are living longer with the challenges of chronic illness, such as lung disease, heart failure, Parkinson’s, dementia, arthritis and cancer. We must improve their quality of life and care, with consideration for where they want to be cared for, which is usually at home.

People often come into hospital because we are not giving them the right support at home or in the community, so one of their symptoms becomes unbearable. If we manage those symptoms better, these hospital admissions could become unnecessary.

I study breathlessness. If you want to know what that feels like, breath through a straw. We take around 12-18 breaths a minute. Imagine if every single breath you took was frightening and made you panic. This is distressing for a patient and for their carer, and it’s one of the most common reasons for hospital admission.

Through my research, I’ve discovered that it’s not only the lungs that help us to breath. Our leg and arm muscles are crucial as well. If these muscles are weak, we need more oxygen and our lungs work harder, leading to greater breathlessness.

We designed a home toolkit to help people lessen the effects of breathlessness. It includes leg exercises, breathing techniques and even a fan to blow air on the face, which is a simple thing that can alleviate breathlessness.

This is just one symptom, but if it’s managed better, it can help people with progressive disease to live more comfortably at home.

I was honoured to be nominated as a Fellow of the Academy of Medical Sciences in 2013 by Professor Sir Robert Lechler, Professor Trevor Sheldon and Professor Dame Sally Davies. Since then, I have participated in several of the Academy’s forward-thinking reports, such as one on multimorbidity, about people living with more than on illness. Most recently, I worked on researching ways to improve symptom management and care at the end of life.

I was also delighted to attend the Academy’s media training for women in medicine, and this has helped me champion the cause of women and science.

The kind of research I’m doing – unravelling the knot of symptoms that people suffer and working out how they connect – is crucial to the future of the NHS. It leads to better treatments and is vital to the way we look after these people and their families.

I am motivated by striving to make care, symptom management and quality of life better for those affected by advanced progressive or terminal illnesses. Palliative care puts the person before their disease and I want my science to do the same.

Professor Irene Higginson is a Fellow of the Academy. To find out more about supporting the work of the Academy, please see our dedicated support us webpage . The Academy is currently developing a project to engage people on the topic of death and dying. For more information visit this page. 

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