When a person encounters any life-threatening disease (cancer, diabetes, neurological conditions, coronary heart disease, HIV/Aids etc.), a traumatising battle for physical and emotional well-being begins.
A life-threatening illness not only takes a toll on the patient but also on the family members. Palliative care is an approach which addresses these issues and tries to improve the quality of the life of the patient as well as family members.
Dr Joyita Deodhar, Head of Department, Palliative Care, Tata Memorial Hospital (TMH) Mumbai and her team are working tirelessly towards improving the quality of life for cancer patients.
Palliative care is still a neglected aspect in our healthcare system. Highlighting this point Dr Deodhar said, “We have 8.4 million deaths in a year out of which one million are due to cancer. These are the people who need access to palliative care but less than 1 per cent of the population have access to palliative care. There are very few palliative care physicians. There is one palliative care physician for one million people.”
Dr Deodhar who is a psychiatrist was working in the field of psycho-oncology before she took over the charge of palliative care unit in 2016 at TMH. According to her, it is important to talk about the quality of death as well.
“We talk about the quality of life but we also have to think about the quality of death. It has to be dignified, pain-free and less suffering. According to a report published by an organisation in 2015, India is one of the worst 15 countries to die in. It means the proper palliative care is not provided to people.”
The palliative care department at Tata Hospital started in 1996. A palliative care unit requires a team of multiple experts of different specialties including physicians, psychiatrists, nurses, social workers, rehabilitation workers etc.
In order to provide effective palliative care teamwork is of immense importance said Dr Deodhar.
Palliative care intends to provide relief from pain and other distressing symptoms to the patient. With the physical and psychological care spirituality is also an important aspect of palliative care.
According to Dr Deodhar spirituality can’t be separated. “In case of life-threatening diseases patients face existential concerns. They wonder what the purpose of their life is. They question faith. These questions have to be addressed,” Dr Deodhar said.
She also explained the need of focusing on staff stress in palliative care. “The staff here is closely associated with morbidity, patient’s death and pain. We are all human beings so it ultimately affects us. To overcome this there should be good connect and network in staff. Whichever staff member is facing a problem, can share it with others. There should be a boundary between personal and professional life. I always say that don’t bring home to work and don’t take work home,” Dr Deodhar said.
Our healthcare system still hasn’t embraced the concept of palliative care. Dr Deodhar throws a light upon what can be done to improve its condition.
“Firstly, we need to tell people what palliative care is. We need to educate them about it. There are only 3 states in India which have a policy for palliative care. There should be access to related services and affordability of the medicines is also important.”