In an attempt to make palliative care accessible to more people, the National Health Mission, Tamil Nadu, is starting a community palliative care programme in 10 districts of the State to provide home-based care to those with prolonged or life-limiting illnesses.
Under the initiative, a staff nurse in each of the 130 blocks of the 10 districts will be trained in palliative care, provided a mobility allowance and given a list of patients who require care. “For many of these patients, it is very difficult to travel to a hospital. We are aiming at the nurse seeing each patient at least once a month. The nurse will also teach the families of the patient how best to provide care,” said Darez Ahamed, mission director, National Health Mission, Tamil Nadu.
The Mission has tied up with Lakshmi Pain and Palliative Care Trust, a Chennai-based organisation, to provide training. “Less than 1% of patients in the country receive quality palliative care,” said Mallika Tiruvadanan, a trustee of the organisation.
Every year, Tamil Nadu sees over 50,000 new cancer cases, adding to the pile of existing cases, as well as hundreds of other chronic illnesses.
“Palliative care starts at the beginning of a diagnosis — it helps in relieving distressing symptoms, including pain, vomiting, breathlessness — and also provides emotional support to patients. It serves as supportive care throughout the illness, alongside treatment,” she said.
And it is not just in cases of cancer that palliative care is required, Dr. Ahamed said. Cancer forms about 34% of palliative care patients, but spinal cord injuries, strokes, cardiovascular diseases and other illnesses too require palliative care.
This will include pain relief management, as well as care of wounds, bed sore, bladder catheterisation, symptom management and other aspects.
Units in hospitals
While nurses are being identified for training for the home-based programme, palliative care units are also being set up in these districts — eight at district headquarters hospitals, and two in medical college hospitals. “The units in Namakkal and Tirupur have begun functioning last month,” said S. Mohana, assistant programme officer, NHM, TN. At each hospital, one doctor and one nurse have already undergone training, and each institution has four beds earmarked for patients, she said. While phase 1 of the project, at a cost of ₹3.68 crore, covers 10 districts, phase 2, which has been approved for 2017-18, will cover another 10 districts, Dr. Mohana said. “Services will be extended to the entire State, and will include geriatric care, daycare chemotherapy, mental health and AYUSH services,” she said.
