#care of terminally ill patient
Caring for Terminally ill Patients
BENGALURU: When a person is diagnosed with a terminal illness, family members, friends and caregivers should be willing to listen to their concerns, say doctors.
Dr L Srinivasamurthy, medical director, Nightingales Home Care Service, says that in order to take care of patients with cancer and other life-threatening conditions such as liver and kidney failure, AIDS, old age senility and other mental illnesses during their terminally ill condition, a broad, multidisciplinary approach should be followed. In order to give effective palliative care family members should be supportive and make use of available community resources. This care can be successfully implemented even if resources are limited. Palliative care can be provided in tertiary care facilities, in community health centres and even in people’s homes and for this, family members should listen or understand the needs of patients.
Palliative care improves the quality of life of terminally ill patients and their families by providing pain and symptomatic relief as well. It also provides spiritual and psychosocial support from the time of diagnosis to the end of patient’s life, he says.
What to expect from palliative care?
- Provides relief from pain and other distressing symptoms;
- Affirms life and regards death as a normal process.
- Intends neither to hasten nor postpone death.
- Integrates the psychological and spiritual aspects of patient care.
- Offers a support system to help patients live as actively as possible until their death.
- Offers a support system to help the family members cope during the patient’s illness and in their own bereavement.
- Uses a team approach to address the needs of patients and their families.
In most parts of the world, a majority of cancer patients are in advanced stages of cancer when they first seek medical help. For such patients, the only realistic treatment option is pain relief and palliative care. Effective approaches to palliative care are available to improve the quality of life for cancer patients. The WHO 3-step ladder for cancer pain is a relatively inexpensive yet effective method for relieving cancer pain in about 90 percent of the patients, says Dr Srinivasmurthy.
In the final stages of life-limiting illness, even the best possible care cannot extend life beyond a point, and hence the focus shifts to making the patient as comfortable as possible.
Depending on the nature of the illness and the patient’s circumstances, this final stage period may last from a matter of weeks or months to several years. During this time, palliative care measures can provide the patient with medication and treatments to control pain and other symptoms, such as constipation, nausea, or shortness of breath, says Dr Shoba Naidu, critical care consultant, Sagar Hospital
When to initiate palliative care on your loved ones:
- The patient wishes to remain at home, rather than spend time in the hospital.
- He/she stops receiving treatment for the disease.
- The patient has made multiple trips to the emergency room, the condition has been stabilized, but the illness continues to progress significantly, affecting their quality of life.
- If a patient has been admitted to the hospital several times within the last year with the same or worsening symptoms.
When caregivers, family members and loved ones are clear about the patient’s preferences for treatment in the final stages of their life, they’re free to devote their energy to care and compassion. To ensure that everyone in the family understands the patient’s wishes, it’s important for anyone diagnosed with a life-limiting illness to discuss their feelings with their near and dear ones before a medical crisis strikes, says Dr Shoba Naidu.
Experts also suggest that it is important to seek financial and legal advice while the terminally ill patient can still participate. Legal documents such as a living will, power of attorney, or advance directives can set forth a patient’s wishes for future healthcare so that the family members are all clear about his or her preferences.