Even as the palliative care is increasingly becoming need of the hour aiming to alleviate a disgraceful pain-crisis a terminally-ill patient and his/her dear and near ones goes through, majority of medical colleges in the country are yet to introduce palliative care in the MBBS curriculum that could ensure sufficient specialised manpower in the sector.
According to doctors, of the 9 million estimated deaths every year due to chronic diseases like kidney and cancer, almost 90 per cent need palliative care that includes discussing the prognosis of the disease, letting the patient and the family talks about their fears and worries or even talking about the financial implications of the treatment.
However, presently, only Tata Memorial Hospital in Mumbai and All India Institute of medical Sciences (AIIMS) in Delhi are offering the post graduate course in palliative care in the country.
AIIMS Director, Randeep Guleria stressed on creating awareness amongst oncologists (for cancer patients reach to the hospital at the last stage), pain physicians and palliative care professionals besides attendants of the terminally-ill patients. “It is essential to address and refute false beliefs and fears of the patients and their families about misery associated with cancer and other chronic illness,” he said adding that such management is needed not only for terminally ill cancer patients but other chronic diseases like kidney also.
It is not just about offering them a pain-free existence but the opportunity to live their life in as much comfort as possible. Palliative care addresses both--physical and emotional sufferings, Guleria explained.
He said that such patients need to be counseled holistically. It has been noted that most of them are most comfortable at the end of their lives at home surrounded by their family. Home-based palliative care is also more cost effective, the doctor said.
AIIMS has not only started MD in Palliative Care and a DM in cancer pain management but has been launching time-to-time awareness drives, public lectures and workshops to sensitise the stakeholders.
Dr (Prof) GK Rath, Chief of IRCH, AIIMS Delhi and Head of National Cancer Institute (NCI) said cancer is preventable, detectable and curable. Unfortunately, because of lack of awareness, majority of patients who reach to us are in their last stage, needing palliative care.
“Providing palliative care to patients at any stage of the disease is a moral responsibility of the doctors. Ideally, it should be started when a person is diagnosed with a chronic or terminal illness and goes beyond the patients' death, with bereavement care and support for the family,” said Dr (Prof) Sushma Bhatnagar, Head of Department, Onco-Anesthesia and Palliative care unit, AIIMS.
Dr Alok Mathur from Union Health Ministry informed that a National Programme for Palliative Care (NPPC) has been already launched in 2012 under the NHM with Rs 10 lakhs support to each palliative care unit. He said that a training manual for doctors and nurses has already been prepared while there are plans to sensitise ASHA workers under the healthcare centres proposed to be set up across the country. Presently, palliative care services are being provided in around 112 district hospitals with Tamil Nadu topping the list, followed by West Bengal.
Other conditions with palliative care needs are - AIDS, muscular dystrophy, dementia, multi-organ failure, Alzheimer’s, Parkinson's disease, end-stage renal disease, heart diseases, those who are permanently bed-ridden and people with neurological problems, added Dr Bhatnagar.