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Painless last breath

Coming to terms with terminal illness is a traumatic experience. The accompanying pain does not make things easier. Such patients find succour in hospices, which seek to relieve them of pain and make their final journey a peaceful one, says SUBHA J RAO.

VEERAMANI IS 43 and battling cancer in the right knee joint and lungs. He is virtually in the twilight of his life as doctors have ruled his cancer too advanced to be treated. What makes the grief of leaving behind his wife and two children behind bearable is the relief from pain. "I had accepted my lot, but used to be in a lot of pain. Thanks to the sedatives and painkillers being administered under palliative care, I am able to live whatever remains of my life in relative comfort," he says.

Terminally ill patients go through a harrowing time while trying to come to terms with their illness and the fact that their final moment is not far away. The accompanying pain only adds to their agony. The families suffer too. Besides the fact that their lives suddenly turn topsy-turvy, they have to steel themselves to see a loved one going through excruciating pain.

When treatment is no longer an option and death becomes inevitable, the only thing that can make life more comfortable for the patients is relief from pain. Hospices are centres that offer palliative care for such people. Both institutional and home care facilities are available to make the transition easier.

In a bid to help such patients and their families, the G. Kuppuswamy Naidu Memorial Hospital started "Raksha", a home for terminally ill cancer patients, on June 30, 2001 as its golden jubilee project. It has now shifted to a new premises in Sengadu. It also operates as a day care centre, where patients can be left for the day when the family has to attend to other pressing business.

What impresses most families about the set-up is the privacy offered at the hospice. Besides keeping unwanted sympathy at bay, it also serves to shield other patients from one person's suffering.

Narayanan, a retired postman, is waging a losing battle against throat cancer. He has undergone a tracheotomy and is being fed through a tube. His daughter says that in a common ward, it used to get very delicate when a relative of someone else who had undergone the procedure asked if things would get all right. "If I told them the truth, their confidence would be shattered. Here, we have our space to grieve and spend time in private."

The fact that medicines and boarding come free has reduced the misery of many who found it difficult to cope with the money drain that cancer caused. Since the food also comes in from the main hospital, the families don't have to worry about hygiene.

Her eyes moist with tears, Veeramani's wife Rajalakshmi says she wants her husband to live happily till his time comes. Hailing as they do from nearby Palani, seeking accommodation in an alien city would have posed problems. Thanks to the hospice, they feel secure that help is not far away. Sexagenarian Subbu from Namakkal, who has cancer of the throat with secondaries in the brain, also feels that way. The painkillers have made his life a little bearable. The staff at "Raksha" is trying to reduce the swelling in his mouth and tongue so that he can at least eat normally.

Of the 148 terminally ill patients who registered with the centre, 86 have died. The staff say they try to cope with a patient's death by recalling his/her positive approach and courage. The team also undertakes home visits within a 25 km radius.

The counsellor says her brief is to reduce patient anxiety. "Normally, their acceptance level is low, they want to extend their life span. Some people also use pain as a mask to their emotions.

We try and make them come to terms with their condition so that they can make the transition from life to death in peace and with courage." Also, families are taught how to open up communication channels and convey their feelings to the patient.

They are also asked to complete certain priorities that need to be done in a person's presence.

The patients are kept here for a short duration to provide pain relief before being sent back home. Relatives are taught how to handle them and the staff follow that up with home visits to ensure the well-being of the cancer victims.

Dr. T. Balaji, a member of the core administrative committee of the GKNM Hospital, says "Raksha" was a logical extension of the Valavadi Narayanswamy Cancer Centre in the hospital. Set up at a cost of Rs. 50 lakhs, the palliative care centre will need a couple of lakhs a month for maintenance.

And, donations are coming in, he says. People wanting to do their bit for those stricken by cancer can donate money for the upkeep of patients, sponsor one of the 15 cubicles in the hospice or provide meals on special occasions.

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