What is Palliative Care?

 Palliative care is specialized care focused on improving the overall wellness of people with life-threatening illnesses. It entails a paradigm shift from the biomedical care model to include holistic support—physical, psycho-social, and spiritual. Since it involves support for the patient’s families or caregivers, it’s sometimes called supportive care. Regarding elderly care in India, this supportive care becomes crucial to provide relief to those experiencing chronic illnesses.

While in the past palliative care was a specialty in hospitals, it has now become an indispensable part of home healthcare. Anyone at any stage of illness can opt for palliative treatment. It is provided by a team of doctors, nurses, therapists, social workers, and counselors. Some of the most common chronic conditions that may require palliative care are cancer, cardiovascular diseases, respiratory diseases, kidney failure, liver disease, multiple sclerosis, Parkinson’s disease, dementia, and many more.

What are the benefits of palliative care?

As a broader continuum of care to improve a patient's quality of life with life-limiting illnesses, palliative care provides multifold benefits. The benefits can be physical, psychosocial, and spiritual as follows:

  • Helps patients understand their choices for medical treatment
  • Improves quality of life and survival through pain management and symptom control
  • Slows disease progression at an early stage of care
  • Aligns itself with the ongoing curative treatment of the terminal illness
  • Allays unnecessary hospitalisation, prevents the financial burden
  • Uphelds patient's decision and navigates various treatment options
  • Reduced risk of depression and mood swings
  • Emotional support to family members
  • Provides extra support when it is most needed

​Palliative Care: A beacon of hope for the elderly care in India

75% of the Indian elderly suffer from one or the other chronic health conditions. Many elderly facing a terminal illness, need special care and support in their day-to-day activities. When the hope of cure and survival dwindles, patients and their families face extreme stress. Care at this stage requires a holistic approach to the patients’ and families’ physical, emotional, and spiritual needs. Fortunately, there are reliable elderly care service at home units providing palliative care that become a beacon of hope and support for those who are grieving.

Palliative care

Improves quality of life, prevents hospitalisation

​Watching your elderly loved one cope with pain, disability, or health deterioration can turn your family life upside down. This is where the support from a palliative caregiver becomes immense both for the patient and the family. Managing pain and symptoms, and supporting families are what palliative care does every day. Home healthcare is also a very important aspect of palliative medicine. Ideally, home is where the elderly are most comfortable and find solace, surrounded by their loved ones. Aside from the emotional and mental benefits, home-based palliative care allays unnecessary hospitalisation and reduces the financial burden on families.

The need for palliative care is more than ever

The current global health emergency of Covid-19 has further highlighted the importance of home healthcare. At a time, when visitors are forbidden, the hospital-based specialty palliative care unit attended to the patient’s anxiety and loneliness. In this context, it is worthwhile to mention that providing palliative care in hospitals can be risky for the elderly who happens to be the vulnerable target of emerging Covid-19 variants and other communicable diseases. Apart from the risk, hospitals are at times overwhelmed with capacity and resources. Home-based palliative care services have been able to respond flexibly and rapidly to de-stress many families.

Unlike in the west where palliative care is recognised under the human rights to health, it is relatively a new concept in India. Its inception in India dates back to the mid-1980s and at present, it remains almost non-existent. As a result, many struggle to receive the right kind of “end-of-life care.” The need for palliative care is pressing due to the aging of the world’s population and an increase in chronic health conditions. The scope is not only limited to elderly care in India but anyone with a chronic illness who wishes to improve their quality of life.

 Examples of Palliative care

Palliative care focuses on reducing the symptoms and stress of the disease as well as painful treatments. The goal is to improve the quality of life by providing relief from symptoms like pain, depression, fatigue, shortness of breath, constipation, nausea, loss of appetite and difficulty sleeping. It can help a patient living with terminal illnesses like:
  • ​Cancer
  • Heart disease
  • Stroke
  • Dementia 
  • Chronic Obstructive Pulmonary Disease (COPD) 
  • Liver disease 
  • Blood and bone marrow disorders requiring stem cell transplant 
  • Kidney failure 
  • Parkinson's disease 
  • Brain or spine injuries from accidents 

Palliative care for cancer

Palliative care specialists can support a cancer patient at any stage of the disease, from diagnosis to advanced stage. It focuses on easing symptoms like pain, nausea, fatigue, and de-stressing from the emotional setback of the disease. Treatment usually depends on the type and particular stage of the disease. Various treatments may include:

  • Medicine
  • Post-operative care
  • Managing side-effects of chemotherapy, radiation
  • Nutrition therapy
  • Physical therapy
  • Relaxation techniques
  • Emotional and spiritual counseling
All these treatments can continue alongside cancer treatments. Opting for palliative care treatment can help someone live longer and more comfortably, even if they cannot be cured.

​Palliative care for cardiovascular diseases

Cardiovascular diseases like heart attack, heart failure, stroke, coronary artery disease, etc., are sudden and unpredictable. Such illnesses impact the quality of life by causing life-long morbidity and impairment. Care methods to decrease anxiety or panic involve:

  • ​Relaxation techniques
  • Meditation
  • Breathing exercises
From providing symptom relief to mental support for end-of-life planning, the team works with cardiologists to provide extra support. It may also include a discussion about the pros and cons of treatment options and hospice care as a future course of care.

 Palliative care for dementia

 Dementia is an incurable illness characterized by progressive deterioration of normal brain functions and cognitive abilities that interfere with daily life activities. Navigating elder care can be an uphill task, especially when dealing with dementia. For example, patients with dementia may experience pain but may not complain about it. It could further aggravate mood changes and agitation. Effective palliative care involving critical decisions about care can improve patients' symptoms, and help ensure that treatment decisions are well-informed and pros and cons are weighed in. Various techniques used are:
  • ​Maintaining a routine care
  • Brain game exercises for memory function
  • Sound sleep habits
  • Calm and quiet environment
  • Psychosocial support for patients and their families
 Since dementia is a progressive disease, advance care planning and coordination may result in improved comfort and better outcomes.

Palliative care for COPD

Chronic obstructive pulmonary disease (COPD) is an all-encompassing term for chronic lung disease that causes coughing and breathing difficulties. It is often a progressive and terminal illness. Early treatment can often help in symptom control and slow the progression of the disease. The palliative care team works with pulmonologist to treat anxiety, fatigue, insomnia, and malnutrition associated with poor oxygen intake. Various techniques used are:

  • ​Medications
  • Breathing exercises
  • Massage and relaxation techniques
  • Counselling to inculcate healthy habits and quit smoking
COPD progress at different rates for everyone. Advance palliative care allows for improving the quality of life and better end-of-life care.

Difference between palliative and hospice care

Palliative care and hospice care are often used interchangeably in the context of elderly care in India. While both focuses on providing symptom relief and comfort to anyone, irrespective of age, there’s an inherent difference. Palliative care is provided in conjunction with curative treatments at any stage of the illness. Hospice care is provided when curative treatment is no longer beneficial or desired, and the patient has six months or less to live if the illness runs its natural course. In short, hospice care is focused on caring, and not curing.

 What is Hospice care?

Hospice care is the end-of-life care to provide comfort and improve the quality of life of a person at the advanced stage of a terminal illness. It involves a multi-disciplinary approach‒medical, psychological, and spiritual support to patients and their loved ones when the disease is no longer curable. The goal of palliative care is to relieve pain and make the transition as comfortable as possible.

Difference between palliative and hospice care

 Can you get palliative care at home?

While home-based palliative care has a proven record of improving quality of life and reducing hospital visits, people at large are not able to reap its benefits. It is because palliative care is still in the evolutionary phase in India, despite being there for more than 30 years. Many factors restrict its usage:
  • ​Restrictive government policies regarding opioid administration for pain management
  • Lack of mass awareness
  • Lack of quality and trained staff in palliative medicine
  • Limited scope of health insurance for home-based palliative medicine
Given the vastly increasing elderly population, lifestyle and illness trends, the need for popularizing palliative care at home is crucial.

At Senocare, we have an experienced team to meet your elderly loved one’s individual needs and deliver personalized elder care home services. Our compassionate Care Managers provide 24x7 one-on-one medical and non-medical assistance to make things simple and comfortable for your family at every stage of life. Starting from the very first discussion, we will coordinate with you throughout the entire journey to take utmost care of your elderly loved ones as though they are our own. Call us today at +91 8800 700 100 or email us at info@senocare.in for more details.