PALLIATIVE CARE SERVICES AT HOME
Age Care Foundation has teamed up with Two Worlds Cancer Collaboration Hyderabad and Pain Relief and Palliative Care Society, Hyderabad, to provide Palliative Care services at the homes of patients. The expertise and resources of these two esteemed organisations are available for Age Care Foundation to access as and when needed.
1. Mission and objectives :
The main goal of palliative care in the home is to improve the quality of life for patients. Receiving care in the patient’s own home is comforting, convenient and reduces stress.
The following palliative services are sought to be provided at home.:
- Medical evaluations, including monitoring for common symptoms like nausea, vomiting, pain, and anxiety
- Prescribing medications to ease these symptoms
- Additional medical applications like treating wounds and other medical needs
- Physical therapy and other rehabilitation needs
- Providing emotional and spiritual support in addition to physical
- Providing social interaction
- Providing guidance on navigating the healthcare system and understanding individual healthcare needs
2. Background and Rationale
India comes near the bottom of the global league in access to end-of-life care—ranked 67 out of 80 countries in 2015—but Kerala is an exception. This small green and fertile state in the south-west has just 3 percent of India's population but provides two-thirds of the country's palliative-care services. The access to palliative care in rest of India, is about 1 to 1.5%.
It is in the benefit of the patient and family that, the patient spends most of the time at his own home, in the familiar environment and also in the midst of near and dear ones. If there is enough family support, patients can be very well managed at home, till the very last days of his / her life. Of course this needs support from a palliative care team consisting of doctors, nurses, counselors, social workers and also allied paramedics like physiotherapists.
It is neither possible nor desirable to admit the patient in the hospital, when the necessary care can be provided at home. This reduces the burden on the patient , his/her family and also on the health care infrastructure.
3. Main Activities
- The deserving patients are selected using criteria like his/her functional dependence, symptom burden, access to health care, financial status and family support.
- A team comprising of a doctor, a nurse, a social worker/counselor and a volunteer visit the patient’s home periodically after giving them prior intimation.
- Patients are assessed for symptoms and also quality of life. Necessary medicines are dispensed or prescribed. Procedures like wound dressing, naso-gastric tube replacement, urinary catheter replacement, enema etc. are done if required. Counseling is done. Family and care-givers are given necessary education and training to look after the needs of the patients.
Home care services are backed by 24 hours telephone support and also the option of admission in to hospice at any time, if the situation demands so.
Targets and Deliverables
We wish to serve about 80-100 persons with health related suffering, with the help of one home care team. The multidisciplinary team visits the patients on five days in a week. We expect that we can do 5-6 patient visits a day depending up on the distance to be traveled on the given day. One day in a week will be earmarked for team review and administrative work.
Depending up on the needs, patients are visited either once or twice in a month. Some of the visits can be by nurse and volunteer team also.
And we have also set ourselves a target of 120 visits every month, which includes doctor led visits and also nurse led visits.