World Palliative Care Day: Building Capacity, Infrastructure towards medical needs

New Delhi: Palliative care is dedicated medical care for people with serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family. The most common and serious symptom experienced by patients in need of palliative care is pain. Most severe pain experienced during advanced progressing conditions like cancer and AIDS demand the need for optimum ways of pain control including use of opioid analgesics. To ensure most effective care for patients, palliative care should be started at the time of diagnosis and continues throughout the treatment, and if need be, the support is even offered to the family after patient’s death.  If cure is possible, palliative care provides pain relief, symptom control and minimizes suffering.

One of the major areas of intervention for Narotam Sekhsaria Foundation, since 2002, has been supporting training and capacity building and infrastructure development in cancer care. It has been committed to making cancer treatment and care available to the patients across all socio-economic strata. Considering the significant role played by prevention, in 2010, the Foundation added cancer prevention to its program on cancer care. Since then it has been supporting capacity building initiatives in the areas of cancer prevention, screening and referral. Another important component in the field of cancer treatment being palliative care – the foundation has now decided to grow its support for palliative care initiatives which can enable communities across socio-economic categories to access care.

Also, considering that availability of medical practitioners in the field of palliative care is the biggest limitation, the Foundation has decided to work towards creating a pool of resources that are scientifically trained in the field of palliative care. We always believe that the Palliative care as a specialized stream of service that needs to find its ground in the healthcare space.

As a step towards that the Foundation along with BMJ has facilitated developing an online course on palliative care. The course is expected to be launched in October 2019 around the World Hospice and Palliative care day (12^th October). It is a three-month online course for physicians and interested medical professionals that has been curated and authored by eminent experts from the field of Palliative care in India and edited by a team of experts in the United Kingdom. The course will enable learners to understand and apply the principles of palliative care in chronic and life-limiting illnesses, help them to identify the palliative care needs of the patients, assess and manage pain and other physical symptoms amongst many more important areas.

The scope of palliative care is not just limited to end of life but to large number of adult and pediatric patients with chronic illness till receiving curative treatment. There is emerging evidence to suggest that palliative care intervention significantly improves quality of life, survival, symptom control, psychosocial issues, communication, and access of health resources and cost of care. Worldwide cancer forms only 25% of palliative care needs in adults and 6% of palliative care needs in children. Therefore, there is a huge need to address non-cancer palliative care need.

According to Dr Monique Kamat, Chief Executive Officer, Narotam Sekhsaria Foundation “Our country is classified under high palliative care requirement region of the world (AS PER Global Atlas of Palliative Care) – about 175-275 people per 100,000 population need Palliative Care services in India However, not all of them have access to it, the gap in the service provision is visibly huge. With increasing trend of Non-communicable diseases and longevity of treatment due to advancement in medical technology – the demand for palliative care services is bound to further increase. Health services and social ecosystem must work together towards making community aware about patients’ rights to provide living will about treatment options in end of life care. Community must be made aware about the significance of home-based palliative care provisions, which has the potential to improve the quality of End of Life Care”.

Due to increasing number of non-communicable diseases and cancer cases, at the same time advances in the medical science and technology – need for Palliative care is ever increasing; There are number of diseases that may require provision of palliative care including: Alzheimer’s and other dementias, cancer, cardiovascular diseases (excluding sudden deaths), cirrhosis of liver, chronic obstructive pulmonary diseases, diabetes, HIV/AIDS, kidney failure, multiple sclerosis, Parkinson’s disease.