Palliative care: A step to make the days count

CHENNAI: With a lot of individuals facing life-threatening illnesses on a day-to-day basis, experts suggest that palliative care is one of the possible solutions to provide relief from the illness.

Dr. Republica Sridharan

Dr. Republica Sridharan, General Physician, RMD Hospitals, who has been treating patients for over 3 decades, explains to us how palliative care became the core when a patient crosses the curative stage of treatment.

Excerpts from the chat with DT Next go as follows:

Q. Is palliative care end-of-life care?

A. Palliative care comes into action when the pain is extreme and the patient does not want to stay as they cannot tolerate the pain any longer. It comforts a patient by managing pain and distressing symptoms. It also is more of psychological, social, and spiritual support rather than just physical support that the patient undergoes.

Yes, palliative does include end-of-life care, but on very broad aspects. A patient with palliative doesn't need to die soon. There have been cases where people are given palliative care for years and are alive.

Dr. Republica also says, “We review our patient's health conditions, change medication accordingly along with focusing on the quality of life, which can be achieved only by pain management techniques.”

Palliative care is provided by a specially-trained team of doctors, nurses, and other specialists who work together with a patient to provide an extra layer of support.

It is based on the needs of the patient, not on the patient’s prognosis, she adds.

We treat people suffering from the symptoms and stress of serious illnesses such as cancer, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), kidney disease, Alzheimer’s, Parkinson’s, Amyotrophic Lateral Sclerosis (ALS), and many more.

Q. What is the average age group of patients that you come across when Palliative is involved?

A. There is no specific age group of patients who come for Palliative care. We have had cases , we've had patients who are kids having advanced cancer. However, the ratio would be more toward elders as they come with multiple symptoms.

Q. Being a doctor, what are the mental challenges that you face?

A. As caregivers, we also require a lot of strength. Mentally there are a lot of setbacks, especially when we see children that too being of us young age.

I have a patient, a mother of 3 kids, who is suffering from breast cancer, one of her sons is a disabled-autistic child. At times it becomes very difficult for us to accept why patients go through this after seeing the disease being progressive.

However there are some cases where the patient fights through and we see a miracle, this gives us a boost to keep going. We take our brief breaks, we get support from the team which allows us to get back on track.

Q. How do you manage your team?

A. We tie up with Tamil Nadu Open University and train volunteers especially the rural young adults who become primary care givers and give them job opportunities.

The palliative care team also spends time and takes a step to help a patient match their treatment choices to their goals.

Q. What is the kind of equipment that is used in palliative care and treatment?

A. There is not much such equipment when it comes to equipment, but it is the human touch that we use to help and understand a patient's mindset. It is more of a holistic approach when compared to any form of treatment and this certainly does help out patients feel a bit more comfortable from the pain that they suffer.

We had a 75-year-old patient who resides in one of our nursing homes, who has telling the doctors that he wants to go to a temple. One fine day, our team took him to a temple and it happened to be his birthday which brought out a cheer in him. He was so overwhelmed by this gesture that he kept kissing the physiotherapist's hand as a gesture of gratitude.

So, this is more of pain-relieving measures that involve very restricted equipment but with more human touch and support.

Q. To sum it up, what are the facilities that RMD provides?

A. RMD helps patients and their families to find qualified, trained, and reliable background-checked home nurses or home health aides for care during hospitalization, post-surgery, or for a chronic condition, elderly care, and palliative care. Our services include Daily Living Assistance, Elderly Assistance, Palliative Nursing, Physiotherapy, Short/ Long Stay Care, Respite Care, Holistic wellness, Therapeutic Yoga Mental Health Counseling, Rehabilitation Physiotherapy, Nutrition Counseling, Therapeutic Massage, Stress Management, Fitness & Life Style Counseling, Reflexology, and Spiritual Wellness.