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A Journey of Home Palliative Care: A Case Study

 Did you know that about 5.4 million Indians are estimated to require palliative care every year?

While most diseases can be cured or managed, some illnesses can turn out to be life-altering and serious. This is where palliative care is of paramount importance. 


Palliative care is primarily concerned with anticipating, preventing, diagnosing, and treating symptoms experienced by patients suffering from a serious or life-threatening illness, as well as assisting patients and their families in making medically significant decisions. It is provided for people with serious illnesses like heart failure, cancer, dementia, liver disease, HIV/AIDS, and more. Palliative or supportive care aids to improve the physical, emotional, spiritual, and social elements of the individual. It starts from the diagnosis of the illness and is continued as terminal care if the illness is progressed until death. 

Improving the quality of life for the patient and their family is the ultimate goal of palliative care. As the end-of-life approaches, care intensifies where aggressive palliation and psychological support are needed.

A critical part of palliative care is helping patients and their families in understanding the nature of their illness and prognosis. Specialists in the palliative care team guide the seniors and their families to establish appropriate medical treatment and to ordinate the goals of the patient with the healthcare team. 

Case Study

A geriatric adult diagnosed with throat cancer (carcinoma supraglottis) availed of Athulya’s Palliative Homecare in Chennai. The individual had a medical history of diabetes mellitus, hypertension, and Parkinson’s disease. They did not present with any surgical history and have reported to have fallen twice. The patient had mobility problems and required assistance to walk, groom, dress, and use the washroom. The patient was unable to take oral feeds and the doctor has suggested PEG feeding. After a discussion with the palliative care physician, the patient and family opted for a nursing assistant service from Athulya.

Following the physician’s consultation, a nurse visited their home to get the preliminary paper works done and to introduce the nurse assistant appointed for the individual’s care. The nurse also conducted a comprehensive assessment that includes personal details, health complaints, medical history, dietary habits, and fall history. The Barthel index (assessment of activities of daily life) and the Morse Fall score (assessing risk of fall) assessments were also conducted.

 

The nurse assistant provided help in fulfilling personal hygienic needs like grooming, oral care, bathing, assisting in bed making, mobilization such as getting up and sitting, feeding, and elimination needs. The nurse also helped in monitoring the individual’s vitals every day.

 

Athulya’s care team along with medical support also focused on providing psychological support to the patient and their family to cope with the effects of the illness. The Palliative Care team of Athulya empathized with the pain of the individual and the family and executed the care plan with kindness, utmost care, and professionalism.

 

Incentives of Palliative Care

Palliative care addresses both the physical symptoms of the disease and the stress of living with it. The benefits of receiving home palliative care are discussed below.

-          Symptom management: With the progression of the disease, different adverse symptoms may arise causing pain and suffering to the patient. The team of palliative care majorly helps in managing symptoms and pain.

-          Amplified quality of life: Initiating palliative care as early as possible can be beneficial. A study revealed that continuing palliative care interventions from hospitalisation revealed significant enhancements in quality of life six months after discharge. Another study compared the effect of palliative care and traditional treatment on the quality of life of people with Parkinson's disease and associated disorders. People undergoing palliative care scored three points higher than those receiving traditional interventions.

-          Reduced healthcare costs: This relies on the concept that when the palliative care patient is cared for well, reductions in complications and unnecessary hospitalization can be expected. 

-          Guidance to medical treatment: Palliative care physicians support the elders and family in making suitable decisions about diagnosis, care, and treatment for the disease. They also offer emotional support to cope with the diagnosis and treatment effects.

-          Delivers satisfaction: Studies report that palliative care provides satisfaction for both the patient and the caregiver.

-          Betterment of mental health: Being diagnosed with or living with a life-threatening illness takes a toll on the mental health of seniors. Fear, anxiety, and depression are common in these patients. A study that evaluated the effect of palliative care in lung cancer patients revealed that the subjects who underwent palliative care showed less depressive symptoms.

-          Supporting pillar for the family: Along with the patient, their family members and friends will be having a tough time. Palliative care extends emotional support for the family to deal with the situation and guidance to consider the right medical care.

 

Conclusion

The objective of palliative care is to ameliorate the pain of seniors and their families with comprehensive assessments and appropriate treatment of physical, mental, social and spiritual symptoms. A multidisciplinary palliative care approach is linked with advancements in the quality of life and improvements in symptom burden. It also provides satisfaction to the patient and family, advanced care planning, and lowered healthcare utilization. Athulya apprehends the individual’s wish to consider care from their homes during such critical phases by providing palliative care services from the comfort of their homes. Visit Athulya Home Healthcare’s webpage to know more details.

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