Q. Could you please tell us about palliative care?
Palliative care treatment has four main stages. The first is explaining the diagnosis to the attendants of the patient. Second is to take care of the needs of the patient. This has two parts – pain management and managing food intake. Third is to guide the attendants through the process of providing care and helping them prepare for the arriving loss of their loved one. We try to provide comfort to them through feelings of depression that naturally arise through such a phase. Then we must look at the course of treatment, as there are also financial limitations of the patient that we must consider. A problem India faces is in the shortage of palliative care experts along with resources dedicated to building hospices and providing palliative care. And so, an important step is to teach the attendants how to take care of the patient, in terms of feeding and cleaning. There is a very low awareness of how to provide palliative care and so we must show them how to do it in a correct manner.
Q. What is the impact of being in this stage of receiving palliative care on the patient and their family?
The aim of palliative care is not to prolong life or cure the disease. We can only provide medicines to give patients as much comfort and relief from pain as possible. While treating patients our role also becomes to provide support to the patient and their attendants to deal with the psychological toll that the diagnosis and illness causes. Upon diagnosis, when we break the news to the attendants that their loved one is going to pass away, they sometimes try and seek opinions from other doctors and hospitals in hopes of finding a cure. But when they do accept that there is no cure, they go into depression. But sometimes when they see the patient getting slightly better because of treatment, they gain some hope. However, when the patient’s health deteriorates again they again fall into a depression and so it becomes a cycle.
Q. What are the problems that are faced?
There is a stigma against hospices in our society. They are seen as places where people go to die, that no one who enters a hospice comes out alive. It is very hard to convince the attendants of a patient to take the patient to the hospice for this reason. In a hospice, the focus is on pain relief and to avoid feeding. By giving terminally ill patient food in their final days, we are only prolonging their pain and suffering. At this stage, we only try to give them as much comfort as possible so they can pass away as peacefully as possible. But there is a shortage of means to invest in and create hospices.
Dr. Arun Kumar Aggarwal is the Head of the Department of Radiative Oncology in Aadhar Health Institute, Hisar. Aadhar Health Institute has been established with the aim of providing best-in-class healthcare facilities. It is offering comprehensive, integrated and quality healthcare through fully equipped ultramodern hospital to people in tier III city at an affordable cost.