The role of palliative care

Updated - May 06, 2020 12:37 am IST

Published - May 05, 2020 11:45 pm IST

Dr Mallika Tiruvadanan, Palliative medicine specialist.

Dr Mallika Tiruvadanan, Palliative medicine specialist.

How can palliative care help when the world is reeling under this most unexpected and unprecedented pandemic, COVID-19? Palliative care is part and parcel of treatment for any patient for any disease at any stage, for any age. It is simply a ‘whole person’ approach to improving health in any patient.

To allay fears and anxieties in patients and families alongside treatment of any illness is not something new in the medical profession.

A 16th century aphorism describes the duty of every physician: “To cure sometimes, to relieve often, to comfort always”.

The literal meaning of the word ‘palliate’ is ‘to alleviate pain — physical and emotional’, meaning, relief of suffering. ‘Suffering’ literally means ‘the state of undergoing pain, distress, or hardship’.

Social suffering

COVID-19, because of its unique nature and magnitude has brought in its wake, not only physical illness, but more of emotional and social suffering — fear, anxiety, uncertainty, loss of loved ones and social distress such as losing jobs and income, inability to move freely to work and other places, frustrations, staying long hours at home and other hardships, all leading to psychological disturbances for many.

‘Palliative Medicine’ is a medical specialty, which involves the treatment of pain, breathing difficulty and other distressing physical symptoms caused by chronic and life-limiting diseases and also addressing the psychological issues of both patient and family, with the sole aim of improving quality of life. It is most beneficial when started early in the disease trajectory.

It is also a form of supportive care, giving that extra layer of support a patient needs, to alleviate suffering, alongside disease treatment even in acute illness.

In the present scenario, in addition to what physicians are toiling with to cure patients, and the government and health care policies and strategies, palliative care can play a supportive role.

The care may be needed right from the time of diagnosis, during treatment of the disease or when treatment does not help anymore to cure.

Supportive role

Distressing physical symptoms like pain, breathing difficulty, restlessness (delirium) and others can be well relieved or palliated with medicines in consultation with the specialists.

Similarly, skilled counselling is an integral part of the palliative approach. It helps address the psychological, social and spiritual issues, which both patient and family are experiencing in the present scenario.

There is a way of responding to their fears, anxieties and to questions. They rarely need antidepressants when we acknowledge their emotions as normal. Active listening is by far the most important part of counselling.

Taking a nonjudgmental attitude without assuming or being philosophical, teaching them special skills in coping with the situation, with the illness or death of a loved one, but always maintaining hope are some basic aspects of communication skills.

These skills can be availed of from psychologists, specialists in palliative medicine, as well as those from medical organisations who have the expertise and willingness to render their services.

Common thread

Palliative care is really the essence of all good medical care. It is the reinstatement of the humane aspects of medical care and is complementary to all medical specialties, a common thread running through the total care of all patients.

Anyone who needs help to overcome their psychological issues can avail of this care by contacting us, We can also put you onto experts who are willing to offer their time and service.

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