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Guide To Understand The Palliative Care In India

Guide To Understand The Palliative Care In India

Palliative Care In IndiaThere are over a million cases of cancer are registered in India every year, which marked over 7.5 lakh deaths in the year 2018 from cancer alone. More than one-third of the patients undergo cancer treatment, and out of which 60% to 90% are already at the advanced stages in cancer disease. It is important for us to review the frequently-overlooked aspect of comprehensive care for the serious illnesses that focuses on providing relief from the pain and improve the quality of life of the patient as well as their families; palliative care in India.

What Is Palliative Care?

WHO (World Health Organization) characterizes palliative care in India as “an approach to improve the quality of the life of patients and their families who are facing problems related to the serious problems and life-threatening illness”. About 80% of the patients (adults and children) dying from cancer desperately need palliative care at the end of life. The said 80% does not include the patients who need palliative care in the earlier times of their illness. Early palliative care not only betters the quality of life, but it also saves you from unnecessary hospitalizations and other health care services.

Palliative Care In India

The public health system of India has made multiple attempts to ease out the availability and accessibility of palliative care. Back in June 2008, the Government of India have collaborated with WHO and formed a group of experts. Its goal was to establish guidelines for developing palliative care in India. This group of experts had made several recommendations in a detailed manual form, which helped the institutions to begin palliative care in the hospitals as well as in the community settings.Palliative Care In India

Ministry of Health and Family Welfare, proposed a strategy for palliative care in India, in November 2012. This strategy helped to form an establishment of the National Programme for Palliative Care (NPPC) under the National Health Mission (NHM). The implementation of this program was under the National Programme for Prevention and Control of Cancer, Stroke (NPCDCS), CVD and Diabetes, along with a strategy for allocating the funds to set up palliative care facilities at district hospitals and creation of the special cells for state palliative care. The funds were allocated in a 60:40 ratio between the center and the states. It was a 90:10 ratio for North-East India and hill states. In the year 2017, there were nineteen states in the country that were providing palliative care in the selected district hospitals.

States like Assam, Kerala, West Bengal, and Telangana, where NGOs are also complementing the efforts of the Government for providing Palliative Care In India.

Their contribution varies from capacity building, technical support, and from healthcare professionals training to recommend and overextend the activities in support of promoting awareness of palliative care.

There are three types of services available in India for palliative care: Outpatient, inpatient (hospice), and home-based care services. An institution offering palliative care can provide any of these three services, a combination of these services, or even all three services at a time.

Outpatient services: Outpatient services take care of all aspects of palliative care in India for patients and their families

Inpatient services: Inpatient or hospice care services are highly recommended for patients who are suffering from serious illness and have symptoms that require professional’s management and term-end (end of life) management.

Home-based care: Home-based care services are for those who are at the advanced stage of their cancer and similar life-threatening diseases and choose to receive these care services within the comfort and privacy of their homes. It is also considered as one of the ways to provide palliative care to the people in rural areas when the health care services are in short supply.Palliative Care In India

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Challenges While Implementing Palliative Care Programmes

The availability of Morphine, which is a scheduled drug and important for the pain management of serious cases. It used to be one of the major challenges for providing palliative care services in India. There were strict rules in earlier times with regards to the supply of morphine drugs. It was severely restricted throughout the country, in accordance to the rules and regulations laid down by the Narcotics, Drugs, and Psychotropic Substances Act of 1985. An amendment to this act was in the year 2014. Morphine and similar pain-relieving medications are available for clinical use by only licensed practitioners, which allows a great relief to the suffering patients.

Next is the low awareness of the patients in seeking palliative care is also a challenge and referral of such patients to palliative care in India by the doctors is a bigger challenge. There is a misconception among the oncologists that palliative care only resembles the end of life care. On the other hand, palliative care focuses on providing the best quality of life in every possible way and at every stage of treatment, right from the diagnosis. The advantage of palliative care at the early stages influences the patient-related outcome too. The lack of awareness for palliative care in India among the medical community leads to a huge number of patients and their families nowhere to seek relief during the treatment.

The Way Forward For Palliative Care

Now, under the newly launched Ayushman Bharat, health and wellness centers are looking forward to provide comprehensive primary health care, which includes twelve packages of health services, one of them mentions about the palliative care services. Though it is a great step in the right direction, but the fact is that palliative care services are still not part of essential packages. Palliative care services are not high-cost services that require a huge amount of capital investment. Well trained and professional staff with an adequate supply of medication are the major factors that affect the quality of care and life for the patients.

NemaElder Care – Center For Palliative Care In India

NemaElder Care is the center for palliative care in India. NemaElder Care focuses on providing relief from symptoms and side-effects of the serious illness. We care for the person as a whole and not just the disease. Our focus is to improve the patient’s as well as their family’s life. Our specially trained staff for palliative care takes care of your physical, emotional, social, and spiritual wellness.

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