Why palliative care is still coming too late for many South Africans
South Africa formally recognised palliative care as an essential component of healthcare nearly a decade ago. However, misconceptions about when it should begin continue to prevent some patients from accessing the care that could support them through serious illness.
Palliative care is not just for the end of life
Palliative care is still frequently associated with the final stages of life, although South African health policy has long recognised that it can begin much earlier. The Association of Palliative Care Centres (APCC) is focusing on this disconnect for World Hospice and Palliative Care Day on 10 October.
The National Policy Framework and Strategy on Palliative Care, adopted in 2017, called for integrating palliative care across all levels of the health system. It defines palliative care as multidisciplinary care for patients and families affected by life-limiting or life-threatening illness, applicable from the time of diagnosis.
According to Motlalentoa Motsoane, CEO of the APCC, the perception that palliative care belongs at the end of a person’s life can delay conversations that could happen much sooner. ‘Too often, palliative care enters the conversation when a patient is nearing the end of life. By then, we have lost valuable time when that person and their family could have been receiving support. We need to change the perception that palliative care is only something to consider when treatment options are running out,’ he explains.
How palliative care can support patients during treatment
Palliative care can help people manage pain and other symptoms while continuing treatment for serious illnesses. It also provides emotional support to patients and their families, helping them navigate the challenges that come with a diagnosis.
Dr Sinalo Maleho of East Rand Palliative Care sees the difference palliative care can make while treatment is still underway. ‘Palliative care helps manage patients’ pain and other symptoms, especially during their treatment programme. This can help them fight their disease more effectively,’ she says.
A young mother’s journey shows what early support can mean
The experience of a young mother cared for by Estcourt Hospice in KwaZulu-Natal shows what this can mean in practice. When she came into hospice care, she was bedbound, paraplegic and had limited movement of her upper body. She was living with HIV and a recto-vaginal fistula, and her aunt was caring for both her and her children.
The hospice brought her pain under control, helped manage her other symptoms and supported her emotionally. Her mobility gradually improved, and she was able to return to her own home. She has since undergone surgery for severe foot drop caused by months of immobility and can now stand with a walker. She is cooking and caring for herself again, with support from her children and partner. Estcourt Hospice continues to assist with transport to hospital appointments and physiotherapy.
Her experience highlights how palliative care can contribute to a person’s quality of life and independence, even when they are living with complex health challenges and require ongoing treatment or rehabilitation.
Changing perceptions of hospice and palliative care
‘This is why we need to change the idea that a referral to palliative care means someone has reached the end of treatment,’ says Motsoane. ‘Palliative care can support people while they are living with serious illness, including while treatment or rehabilitation continues.’
The APCC is highlighting stories like this from its member organisations as part of its World Hospice and Palliative Care Day 2026 campaign. They show that much of the palliative care South Africans need already exists, but too many people still reach it too late. The campaign asks: Imagine if everyone who could benefit from palliative care actually received it?
Why earlier conversations matter
Motsoane says this will require healthcare professionals, patients and families to think about palliative care earlier. ‘Healthcare professionals need to recognise when palliative care could help and know where to refer. Patients and families also need to know that they can ask about it before the final stages of illness. The sooner those conversations happen, the sooner people can find out what support is available to them.’
To find an accredited palliative care provider in your area, visit the the Association of Palliative Care Centres.
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Featured Image: Magnific
