Role Of Palliative Care In Patients Suffering From Chronic, Serious And Life Threatening Diseases

Imagine the hardships being faced by patients suffering from chronic, serious and life threatening conditions, being treated at mainstream hospitals by specialists/superspecialists. Their focus is only on controlling the disease and physical symptom. But most of these patients and their family members are going through lot of Psychological, spiritual and social problems also, which are not being addressed at all. Do you think these hospitals can improve the quality of life of these patients and their family members? Yes, they can if they have trained palliative care specialist and nurses, which most of them don’t have.. This is where Palliative care bridges the gap, by shifting the focus from disease to the patient and from curing to healing. This is done by providing holistic care by Multidisciplinary Palliative Care team.

What is Palliative Care?

Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stresses of the illness. The aim is to improve the quality of life for both the patient and the family members.

Palliative care is provided by a specially- trained team of doctors, nurses and other specialists who work together with a patient's family doctor and other doctors to provide an extra layer of support. Palliative care is based on the needs of the patient and not on the patient's prognosis. It is appropriate at any age and at any stage in a serious illness, and can be provided along with curative treatment.

Diseases Requiring Palliative Care

Cardiovascular disease (38.5%), Cancer (34%), Chronic respiratory diseases (10.3%), AIDS (5.7%), Diabetes (4.6%), Many other conditions may require palliative care, including kidney failure, chronic liver disease, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, dementia, congenital anomalies and disabilities.

Symptoms requiring Palliative Care

Physical Symptoms: Severe Pain, breathlessness, fatigue, pressure symptoms, bed sores lymphoedema, bleeding, difficulty in eating, swallowing, immobility, jaundice etc.

Psychological Symptoms: Disruption of sensitive balance between the mind and body, unpredictability of future, depression, difficulty in finding someone confidential to talk to, loneliness, getting little support from the family & others, fear of physical suffering & death, stigma due to disfigurement, loss of self-esteem & suicidal thoughts.

Benefits of Palliative Care:

• Relieves pain and other physical symptoms
• Relieves emotional, psychological and spiritual problems
• Improves quality of life, interpersonal relations and survival rate
• Helps in developing a positive attitude, after accepting the normal course of the disease and its progression
• Makes people understand that with willpower and medical support, patients can regain their normal lifestyle, and live symptom-free, comfortable, independent and dignified life for years to decades as far as possible
• Trains the family members/caretakers to manage the patient at home in consultation with the multidisciplinary team of the Palliative Care Centre
• Saves money and time being spent on unnecessary investigations, procedures, admissions, ICU care and ventilator care, by shifting the focus from disease to the patient and from curing to healing.

Where is Palliative Care Given?

At home by family members, under the supervision of palliative care team, Palliative Care OPD, Palliative Care Unit of Hospitals, Dedicated Palliative Care Centers.

For how long is Palliative Care required

From weeks to months to years. It all depends on the diagnosis, Organ involved, Stage and grade of cancer, patient’ age, his/her general health, attitude and will to fight the disease after accepting the disease.

To conclude

It is estimated that 56.7 lakhs people require Palliative Care in India per annum, but it is available to only 1% of population. It is also estimated that 60% of people dying annually will suffer from, prolonged advanced diseases including Cancer, COPD, end stage heart, liver, kidney failure etc. and will require palliative Care. Less than 3% of cancer patient of India have access to ADEQUATE PAIN RELIEF. There are very few dedicated palliative care centres in India, inspite of endless efforts of many NGOs. Opoids (high end pain killers) are not available to most of the patients for pain relief.

It is high time, PALLIATIVE CARE is made accessible, available and affordable to maximum number of people who require it.