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Palliative Care: Not Counting Days but Making Days Count
By Dr Lavina M Noronha

October 8, 2011

One of the recent additions to the multifaceted disciplines of health is Palliative Medicine and hospice care. International hospice and palliative care is celebrated this year on the 8th of October. Despite being the youngest branch of system, palliative care is slowly but steadily spreading worldwide.

Originating from the Latin word “palliare” which means to cloak, palliation literally cloaks the patient diagnosed with an incurable, debilitating disease in tender loving comfort care. The goal here is not to prolong life or to expedite death but to increase the quality of life of a person. Therefore, any patient diagnosed with a progressive and life-threatening disease like cancer, kidney failure, malignant brain tumor, liver failure, or dementia is eligible for palliative care.

Dame Cicely Saunders, who is considered the founder of modern palliative care movement, puts it this way: “You matter because of who you are. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but also to live till you die.” It is because life matters till the end and everyone deserves to have a pain-free, peaceful death, a multidisciplinary team consisting of physicians, nurses, counselors, social workers, chaplains, and volunteers join hands in taking care of the physical, psychological, spiritual and social needs of a patient and his or her family. Palliative care approach is holistic- thus addressing all facets of human life and one of the unique features hospice/palliative care is that the patient and the family plays an active role in caring for the patient.

According to World Health Organization (WHO), Palliative care is "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual."

Palliative care can be provided at any stage of a life-limiting illness and alleviating pain and suffering in patients diagnosed with terminal conditions is the focus of medical and nursing care. In those suffering from Cancer for example, the adverse effects of radiation and chemotherapy need professional attention. Additionally, in the end stages when the cancer metastasizes or starts spreading from the primary site to other organs, excruciating pain, draining wounds, fungating ulcers, loss of appetite, nausea, vomiting, insomnia and other distressing symptoms that surface also need to be taken care of.

Due to the commercialization of health care, aggressive medical interventions like surgical procedures, dialysis, radiotherapy or chemotherapy have become the most exhausting options which leave the patients and their families completely drained. The knowledge that death is just around the corner sometimes brings with it feelings of anger, denial, or anxiety which have to be addressed in a timely manner. Patients and their families often harbor feelings of hopelessness and helplessness that require understanding and psychological support. Similarly, preparation for final good byes, anticipatory grief issues and bereavement also come under the realm of palliative care.

Very often patients are confronted with deeper philosophical questions about life and death. Concerns about the end, death anxiety, life beyond death are legitimate and need attention.

Respect for the dignity and worth of human life is an integral aspect of palliative care. There is a need to prepare everyone to accept the ultimate inevitability of death. Enhancing the comfort levels of patients and affording an opportunity for healing on psycho-spiritual levels are essential in the end-stages of life.

 

Dr Lavina Noronha - Archives :  

 

 

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Comments on this article
Dexter Britto, Mangalore/AucklandFriday, October 14, 2011
Dear Dr.Lavina,

Thanks for this interesting article which I shared with many others all of whom wrote back saying they found it very informative.

This concept is also very aptly depicted in the movie "Patch Adams" which demonstrates that treating a patient with respect, dignity and compassion can make a difference even when days are numbered.

Read all your previous articles as well and I can see that you have the unique ability to connect with each of your patients.

Thanks for sharing your insights on so many topics.
Comment on this message

Christopher D'Cunha, M'lore/AUHTuesday, October 11, 2011
Dear Shivani You should get in touch with Dr. Lavina, writer of this article, with much difficulty she is running a Ave Maria Palliative Care Center in Mangalore You can join hands with her. Her email ID is:lavnoronha@hotmail.com
Comment on this message

Raina ROdrigues, MangaloreMonday, October 10, 2011
Dear Dr.Laveena, you are doing a very good job, which only few can do. would like to get in touch with you and also visit Ave Maria. this is my email id raina.rodrigues@gmail.com kindly emaill me your number and address. keep up the good work.
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Shivani, Dublin/MangaloreSunday, October 09, 2011
There s a growing need for services who provide palliative care. At home,its very difiicult to take care of some with life limiting illnesses. They need care from trained people and a way to get pain relief.
Me and my husband are very much interested in opening a palliative centre in and around Mangalore/Udupi but unfortunately due to the financial constraints we have put our plans for future. It would be a good service that is very much the need of the Present time.
Comment on this message

Francis Noronha, kota/bombaySaturday, October 08, 2011
Dear Dr.Lavina,
Thank u for the article.

I to hv similar problems
I hv only one son, from the birth he is donwnsyndrome and very poor eyesite
we parents taken all care.
now we both parents retired and taking care of our son.
Would u pls advise us: is there any
private body or any institution,home are avilable to take care of him in case of our death?
rgds
Francis Noronha
Comment on this message

Shahina , LakhaniSaturday, October 08, 2011
A wonderful article about the need and full scope of palliative care. What kind of programs are available in India to train healthcare professionals in addressing philosophical/existential issues at the end of life? In USA there is great emphasis on physical care and a need to improve focus on philosophical/existential/spiritual concerns. Holistic care is usually brushed aside due to "lack of money" to train the staff.
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