Palliative care consists in caring for patients suffering from pain for a long time. Patients suffering from Cancer, Aids, Cardiac or renal diseases, paralysis and others require palliative care. It is generally misunderstood that only people who are terminally ill or those whom doctors have given up hopes of any progress, go to palliative care centers. Far from true. Any patient suffering from intense pain requiring long term care can benefit from Hospices. The objective of hospices is to improve the quality of life and render living passable.
People requiring palliative care have four types of problems:
o Physical problems: These arise out of pain, nausea and vomiting, breathlessness, ulcers that do not heal
o Psychological problems: depression, anger or denial in response to the illness, emotional isolation
o Social problems: Unemployment, inadequate finance for medical treatment / hospitalization. Loneliness and abandonment by children or relatives
o Spiritual: Why has GOD chosen to punish me? Why should I live any longer? What is the purpose of my life?
Hospices address all the issues in an integrated way. Where needed, medicines like morphine are given in required doses to reduce pain. Wherever supplemental medical treatment or other interventions like chemotherapy, ration therapy, dialysis etc are indicated, these are provided with the support of nearby hospitals. Counseling is provided to make patient understand and accept the reality. Love, care, company, psychological supports are all given.
Situation in India
The concept itself is relatively new to India. It is hospice care service believed that even the few centers that have come up in recent years have their origins in the spurt in medical tourism targeting India. Palliative care centers in India are woe fully inadequate as there are only about 55 such centers, that too only in major cities. Providing care in hospices requires multi-disciplinary skills. Nursing and medical courses make just a passing mention of this service. Indian Association of Palliative Care, Kozhicode, Kerala, Pallium India again in Kerala, Karunashraya in Bangalore provide short term training programs for personnel to be employed in Hospices. Christian Medical College, Vellore offers PG courses in Palliative Medicine supported by its 2000 bedded hospital and a full fledged hospice. If we consider just cancer alone there are nearly one million patients added every year. All major cancel hospitals put together can not handle so many patients. Exclusive hospices are needed.
Senior Citizens Homes
There are a large number of Senior Citizens Homes (Elder care facilities) on payment basis in all major cities of India. Hyderabad alone has more than 150 Old Age Homes. Many of these are attached to regular hospitals and nursing homes. Many are run by qualified medical professionals. Such senior homes accept senior citizens who are sick, immobile or terminally ill.
With some changes in objectives, facilities, staff training and physical infrastructure, many of the Senior Citizens homes can be converted into reasonably good palliative care centers or hospices. Senior citizens who want to volunteer their time may spend time in such centers to give company and counseling. For instance there is an acute need for talking care of dementia or AD patients.