What is Palliative Care
Palliative (acr. Pain-Alleviation) Care is the treatment of distressing physical symptoms and emotional issues caused by chronic and life threatening diseases. The sole aim of the care is to improve Quality of Life for patient and family.
According to the definition of health by the WHO in 1942, “Health is a state of physical, mental, social and spiritual well-being…” the duty of every physician is to treat any patient in this holistic manner. Since advances in medicine has made medical training more disease oriented than patient-oriented, Palliative Care is considered as, ‘Old world medicine –REBORN’ to fill the gap between cure and care! Palliative care is complimentary to all medical specialties as part of treatment and good old wholesome medical care! Palliative care cannot be equated to terminal care! It is a ‘NEED-BASED’ care to be available for patients throughout their illness from the very beginning, to ‘palliate’ the distressing symptoms as and when they arise.
Misconceptions about Palliative Care & Treatment
Palliative Care is for patients for whom doctors have nothing further to do
This is a myth! Patients may reach a stage when there is no more treatment for the disease & palliative care is the only option. But this does not mean they do not suffer before this stage! Palliative Care is NEED-BASED and helps the patient and family as and when the need arises, throughout the illness.
Is not Palliative Care ONLY about counseling?
This is a MYTH. Aim of Palliative Care is to improve quality of life. This cannot be achieved by Counseling alone. Patients’ distressing physical symptoms need to be treated first before addressing their emotional issues. For example, a patient in severe pain cannot be counseled till his physical pain is first relieved! So, Palliative Care includes medical treatment of the physical symptoms as well as counseling to relieve the emotional distress.
Morphine is the only medicine given in Palliative Care.
This is a baseless statement as Morphine is purely a pain relieving medicine. Many patients can also suffer from many other physical symptoms such as vomiting, breathing difficulty, foul smelling non-healing ulcers, urinary, gynecological and neurological symptoms for which appropriate medicines are given.
FAQ
What is PALLIATIVE CARE?
Palliative Care is the active medical treatment given for relief of pain and other symptoms in patients with prolonged and life-limiting illnesses like cancer. It is a ‘WHOLE PERSON’ approach which includes addressing not only the physical, but also the psychological, social, spiritual, and financial issues of both patient and family. The aim of Palliative Care is to improve quality of life by enabling patients to be as active as possible and also to cope with the disease, whatever the stage!
What is the difference between Palliative Care & Hospice Care?
Palliative Care is a wide spectrum applicable right from the time of diagnosis, through treatment phase and in the advanced stage and goes even beyond death to the bereavement phase.
Hospice Care is similar to palliative care but applies to only those chronically ill patients who are predicted to live for not more than 6 months. In the western countries this arrangement helps insurance facilities. The CARE is the same – relieving physical and emotional suffering and improving quality of life.
Hospice Care is similar to palliative care but applies to only those chronically ill patients who are predicted to live for not more than 6 months. In the western countries this arrangement helps insurance facilities. The CARE is the same – relieving physical and emotional suffering and improving quality of life.
If a patient is referred to a specialist in Palliative Medicine, does it mean he is in the terminal stage?
NO, DEFINITELY NOT!! ‘Palliate’ means ‘relieve suffering’ When does suffering begin? It could start from the very time of diagnosis of a dreadful disease like cancer!
Palliative Care can help right from this time when both patient and family need skilled counseling and compassion to understand their emotions – fears, anxieties dilemmas related to decision making – and address them accordingly. The care may be needed during active treatment of cancer and other chronic diseases (for treatment of side effects) and more so in the advanced stage. It is a form of SUPPORTIVE CARE adding an extra layer of support to the patient and family by relieving their distressing physical and emotional symptoms throughout the disease trajectory including the treatment period. In fact, Palliative Care is now considered as part of treatment of any disease at any stage and at any age. (WHO Mandate May 2014)
Palliative Care can help right from this time when both patient and family need skilled counseling and compassion to understand their emotions – fears, anxieties dilemmas related to decision making – and address them accordingly. The care may be needed during active treatment of cancer and other chronic diseases (for treatment of side effects) and more so in the advanced stage. It is a form of SUPPORTIVE CARE adding an extra layer of support to the patient and family by relieving their distressing physical and emotional symptoms throughout the disease trajectory including the treatment period. In fact, Palliative Care is now considered as part of treatment of any disease at any stage and at any age. (WHO Mandate May 2014)
We don’t want to opt for Palliative Care. We don’t want to give up as yet.
An often heard sentiment!! Again a MYTH as the wrong message is unfortunately conveyed by professionals themselves sometimes to the public that Palliative Care is applicable only for the terminal stage. Many patients have said, once their quality of life improved, “I wish we had seen you earlier!”, implicating that they had suffered in various ways earlier. The awareness that Palliative Care is not just ‘end of life care’ has to be spread among the medical fraternity and the public, so that no one suffers from pain, both physical or emotional, at any stage of an illness!
Who should reach out for Palliative Care?
Any patient who undergoes suffering due to any chronic disease at any stage, can reach out for Palliative Care, including those who are undergoing treatment and likely to get cured. Examples: patients with cancer, chronic liver disease, chronic kidney, lung and heart disease, HIV-AIDS, age-related and neurological illnesses and also those who suffer from longstanding pain like chronic arthritis or low backache.
When should we go to a Palliative Care doctor, if diagnosed with a life limiting illness?
From the time you develop fear, anxiety or need to clear doubts, from the time the patient or the family feels they need support for their physical and/or emotional suffering, which may be from the very beginning! Palliative Care can be adopted side by side curative treatment or whenever there is a need to relieve any distressing symptom due to the disease at any stage.
Can a family member of a patient reach out to Palliative Care?
Of course, family members are the primary caregivers. Any query from them will be answered and clarified. After all Palliative Care is supportive care for patient AND family, because when a person is diagnosed with a life-limiting / chronic illness, the family is also affected in various ways and may need guidance and a sense of direction.
Do Palliative Care doctors come on home visits?
Yes, most doctors specialized in Palliative Care do make home visits when the need arises. Each patient is assessed individually and if at any stage a home visit is necessary to help palliate, doctors, or their team, do the needful. Sometimes it could be enough even for a trained nurse or volunteer, to make the home visit.
Can Volunteers do Palliative Care?
YES!! After a basic training in Palliative Care, volunteers can help those in need by being a part of the team of doctors, nurses, psychologist and social workers. A large part of the suffering experienced by patients and caregivers are emotional, social and spiritual. With background knowledge of palliative care and the guidance of palliative specialists, volunteers too can help in many ways to improve quality of life in both patient and family by volunteering their time for the cause.
Can cancer spread from one person to another?
CERTAINLY NOT!
Cancer is not an infection and is a not contagious! disease. It will NOT spread from one person to another. You can live in the same room and eat from the same plate! You can touch and take care without any fear or doubt.
Cancer is not an infection and is a not contagious! disease. It will NOT spread from one person to another. You can live in the same room and eat from the same plate! You can touch and take care without any fear or doubt.
One of my family members had cancer. Will I also get it?
Not necessarily.
But certain cancers may be hereditary which means a person may be at a higher risk of getting cancer if his/her relatives have had that particular cancer e.g. breast, ovarian, colorectal cancers. When in doubt write to us or talk to your doctor..
But certain cancers may be hereditary which means a person may be at a higher risk of getting cancer if his/her relatives have had that particular cancer e.g. breast, ovarian, colorectal cancers. When in doubt write to us or talk to your doctor..
Does morphine tablet help ALL KINDS of pain?
No! Morphine is the drug of choice to relieve the constant, severe ‘wound type’ of pain which is commonly seen in cancer. Other commonly used pain killers are given for mild to moderate pain. But pain can be of other kinds: Example, nerve pain due to injury or compression of nerves, colicky pain related to stomach or intestine, muscle pain and headaches. In all these situations, morphine will not help and different types of pain killers according to the cause of the pain need to be given.
Does taking morphine tablets mean that the disease is advanced?
NOT NECESSARILY.
According to the World Health Organisation (WHO) Guidelines, Morphine tablet should be given for severe pain WHENEVER it occurs during a cancer illness. Severe pain is a common side effect of chemotherapy and radiotherapy, but it can be well relieved with tablet morphine which can be stopped when pain subsides after treatment is completed. Without this pain relief, patients may refuse to continue treatment and even lose the opportunity to get cured or control of their disease! Good PAIN RELIEF helps them COMPLETE their TREATMENT and GO BACK TO social circulation. Severe pain is more common in the advanced stage due to spread of the disease and the drug is used more often at this stage.
According to the World Health Organisation (WHO) Guidelines, Morphine tablet should be given for severe pain WHENEVER it occurs during a cancer illness. Severe pain is a common side effect of chemotherapy and radiotherapy, but it can be well relieved with tablet morphine which can be stopped when pain subsides after treatment is completed. Without this pain relief, patients may refuse to continue treatment and even lose the opportunity to get cured or control of their disease! Good PAIN RELIEF helps them COMPLETE their TREATMENT and GO BACK TO social circulation. Severe pain is more common in the advanced stage due to spread of the disease and the drug is used more often at this stage.
Doesn’t Tablet Morphine lead to addiction?
NEVER! First I ask, “Will doctors prescribe an addiction causing medicine?!
What is addiction? It is the ‘kick’ (euphoria) that one gets when an addiction forming chemical gets absorbed rapidly into the blood circulation. This can only occur with drugs that are inhaled or injected and not with the tablet. An addict’s abnormal behavior is in clear contrast to the normal behavior and functioning of the patient’s. Millions of patients all over the world are given this tablet with NO REPORT OF ADDICTION. (Please note: It is only the injection form that can lead to addiction, that too only when taken by normal people and not in those with severe cancer pain!)
What is addiction? It is the ‘kick’ (euphoria) that one gets when an addiction forming chemical gets absorbed rapidly into the blood circulation. This can only occur with drugs that are inhaled or injected and not with the tablet. An addict’s abnormal behavior is in clear contrast to the normal behavior and functioning of the patient’s. Millions of patients all over the world are given this tablet with NO REPORT OF ADDICTION. (Please note: It is only the injection form that can lead to addiction, that too only when taken by normal people and not in those with severe cancer pain!)
Isn’t Palliative Care 'end of life care'?
‘End-of- life’ care is only one aspect of Palliative Care. ‘Palliative Care’ refers to a wider spectrum, applicable from the beginning to the end-of-life stage and includes bereavement care. The term, ‘End-of- life’, is often used in the west where it is referred to a patient with a ‘serious illness’ but can live for a few years. But in the east, we have the tendency to equate ‘End-of-life’ to ‘terminal’ care; hence the use of the term, ‘Palliative Care’ is to be encouraged in our country and ‘End-of-life’ only to those who are not expected to live for more than a few months.
How can I get the support of Palliative Care, if I want it?
Simply call or email us or any other organization trained in the field.