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Department of Palliative Care- Home Care

department of palliative care- home care

Home Care Services pledges to provide supportive services to metastatic terminally ill patients, regardless of age, race and religion.

“WE SHOULD PUT LIFE INTO THEIR DAYS,
NOT JUST DAYS INTO THEIR LIVES”

Concept of Palliative Care
The word ‘palliative’ is derived from the Latin word pallium, a cloak. Palliation means cloaking over, not addressing the underlying cause but ameliorating the effects.

The goals of Palliative Care are:

  • Achievement of the best possible quality of life for patients
  • Good control of symptoms
  • To facilitate adjustment to many ‘losses’ of advanced and terminal illness
  • To facilitate and guide completion of unfinished jobs
  • A dignified death, with minimum distress
  • Prevention of problems in bereavement

The bedrock of the palliative philosophy is patient centered holistic care, focusing on quality of life and extending support to family and care givers. This is encompassed in the following adapted quotation:

“You matter because you are you, and you matter until the last moment of your life. We will do all that we can, to help you, not only to die peacefully, but to live with dignity until you die.”

What does a patient need?
Patients need autonomy and choice, including the right to deny treatment; right to confidentiality and wherever possible, to choose the setting of death and degree of care givers involvement. In simple words, the patient needs information, good quality of life and a dignified death.

Information
A patient needs sensitive, clear explanation of:

  • The diagnosis and its implications
  • The likely effects of treatments on activities of daily living
  • The type and extent of family / care givers support
  • Expected symptoms and what may be done about them

Quality of life
A patient has a need to lead a life that is as normal, congenial and dignified, as possible. An individual’s quality of life will depend on minimizing the gap between his expectations / aspirations, vis a vis his actual experiences. This may be achieved by:

  • General respect, as a person / patient
  • Effective relief from pain and other distressing symptoms
  • An appropriate and satisfying diet
  • Comfort and consolation, especially from those who share the patient’s religious beliefs
  • Consistent and effective response to changes in physical and psychosocial discomfort
  • Information about support and self-help and other groups and services

There is always something more that can be done to help a patient but it is not always possible to completely relieve symptoms. Specialist advice may be sought for help in the management of intractable symptoms. An acceptable solution must be found to provide adequate relief of distress for the patient.

Symptoms which need to be relieved

Pain occurs in up to 75% of patients with advanced cancer. The experience of pain is influenced by physical, emotional, social and spiritual factors. Patients with an advanced disease usually have constant pain and therefore require analgesics taken at regular intervals. Some patients may seek the techniques of complementary therapy (Relaxation techniques, Hypnotherapy, Aromatherapy massage, Homeopathic remedies etc.) to control their pain. Analgesics need to be given at regular interval. Drugs like Morphine, Fentanyl etc. may not be freely available in open market but are available on prescription of Palliative Care Team.

  1. Gastrointestinal symptoms – Questions regarding dry and sore mouth, appetite, nausea and constipation should always be considered. Many patients who suffer unrelenting nausea find this more disabling than pain. Constipation can cause considerable distress, requiring laxatives or dietary modifications.
  2. Respiratory symptoms – As many as 70% of patients with cancer will experience significant breathlessness in the last few weeks of life. In patients with end-stage Congestive Cardiac Failure (CCF) or Chronic Obstructive Pulmonary Disease (COPD), prevalence may be even greater. The three commonest respiratory symptoms are cough, breathlessness and hemoptysis (blood in sputum). Symptomatic relief may be given with medications & oxygen inhalations etc. at home.
  3. Managing complications of cancer – Metastatic or advanced cancer may cause complications which require urgent intervention to palliate symptoms and either restore function or prevent deterioration. Such complications often have a profound effect on a patient’s functional ability and quality of life. Patient may need referral to medical centre for problems like stridor, impending paraplegia, leakage from tubes, retention of urine etc.
  4. Care of children – Parents bear a heavy responsibility for nursing and personal care of their child and most take on burdens willingly. Problems which children face are pain, feeding related, neurological, respiratory etc. Parents need guidance as well as emotional support.
  5. Other common problems
    • Cachexia, Anorexia – may require tube feeding, I /V Hydration, TPN etc.
    • Wound Care, Pressure Sores Care
    • Catheter / Drain Care
    • Lymphoedema

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What do we provide?
Our goal is to provide holistic care and improve the quality of life, in the last days
of the journey of life

  • A qualified Doctor, a Nurse & Medical social worker / Counselor visit at your door step
  • Clinical assessment
  • Symptomatic treatment
  • Nursing care & Procedures
  • Health education to patient and relatives
  • Provide medicines for pain relief and nutritional supplements & Medical equipments all free of cost.
  • Emotional support for patients and family members
  • Work towards improvement of quality of life in your own environment and provide comfort to patient and his family
  • Knowledge to caregivers about preparation of home based mouth wash, vaseline gauge and bed sore dressing ointment.
  • Knowledge to caregivers and patients about alternative therapies such as:
    • Reflexology
    • Relaxation exercises
    • Spiritual healing
    • Special massage for lymphedoma patients
    • Bereavement services

Area of operation
Whole of Delhi

Who can get enrolled?
The services are provided to patients who are registered with RGCI&RC.

Achievements
RGCI & RC at its inception in 1996 on an average 1000 patients per year are benefitted by our services.
All the services, activities educate, encourage patient and care givers, family members.

For enrollment contact details
Department of Palliative Care/Home Care
Room No. 1A
(3:00 pm – 5:00 pm)
Tel.: +91 – 11 – 4702-2207
E-mail: chugh.veena@rgcirc.org

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