Palliative Care in Hyderabad

The Pain Relief and Palliative Care Society is a not-for-profit registered charitable organization registered under registrar of societies act. The society works in the field of Palliative Care and End of Life Care for patients living and suffering with incurable diseases like Cancer in the city of Hyderabad and Secunderabad. All the patients cared under palliative care are the below poverty line lower socio-economic group.

Patient support in the outpatient ward of MNJ Cancer Hospital: In the past three months we have catered to about 2820 patients including new and review in the departmetn of pain & palliative care. Our doctors, nurses, conselors and volunteers strive to provide the best palliative care in the hospital for both patients under curative and palliative intent.

Pediatric Palliative Care: We have a dedicated pediatric palliative care program at our MNJ Cancer Hospital and the same children will be taken care during their end of life care through home care service and hospice care which is a unique pediatric palliative care program to cater for special needs of the children. We support children with cancer and their families in their battle to overcome the illness by providing the emotional support, counseling, ‘food for survival’, travelling expenses, special school for children, rehabilitation and recreational activities. We have seen 970 children in the past 3 months.We also introduced the pain scales on every child’s bed as self reporting as they can report us their pain score every day and show us how they are feeling that particular day.

Home Care Program- Life At Your Door Step: Our program is providing a comprehensive home care program, 24 hour/7 days a week to patients and families struggling with advanced and terminal illness in the city of Hyderabad and Secunderabad. The dedicated home care team not only attends to physical problems such as severe pain, breathlessness, malignant wounds, and confusion, but provides skilled psychosocial and spiritual support. Educating and preparing the family for expected changes at the end of life is another key role of the trained team. In the past three months we have cared for about 430 patients who are in their end of life care and deserve palliative care as less than 1% patients have adequate access to pain & palliative care and end of life care.

Hospice Program - Living Well and Dying Better: Our 26 bed in-patient facility of a Hospice caters to those patients who cannot be taken care in their homes. We are providing 24*7 medical care by full time doctors, nurses and attendants. In the past three months we have admitted and cared for 194 patients in our set up by provinf end of life care and palliative care. Our centre is provinding free food for the patient and a care giver in addition to free treatment and medicines. We also shuttle patients between MNJ Cancer hospital and the hospice and when the patients die we transfer their bodies in a dignified manner to their respective homes free of cost.

Community Outreach Program: In our program we have completed the door to door survery of 30 villages and identified 200 patients including cancer, HIV, Demntia, Celebral Palsy, Paraplegia, Quariplegia, Stroke, Juvinile Diabetics, bed ridden patients etc who are spending most of their time at home and they are in desperate need of accessible medical care to help them cope with chronic and life limiting illness. Our team is now making regualr visits to the villages to take care of them along with doctor, nurse, physiotherapist and sometimes an expert in a specilaixed care. 

Report on the Activities of Pain Relief and Palliative Care Society for the period 1^st July to 30^th September 2015

The PRPCS has four main activities to take care of end stage cancer patients in Hyderabad. The activities in each of these four programs during the above period were as under: 

1) Supporting the Department of Pain palliative care in MNJ Government Cancer Hospital. On and average forty patients per day who were discharged from the wards of the hospital were referred to the dept for palliative care. Our volunteers and social workers have interacted with each one of these patients and their care givers at a personal level to understand their difficulties, emotional and financial problems and counseled them to cope with the traumatic period they will have to undergo. At this stage the patients were also segregated depending on their condition in two three groups namely those who can continue to come to the hospital for receiving medical care and medicines, those who will have to be treated at their respective homes and finally those who have to be admitted to the hospice as in-patients.  

2) Home based programme- As many as thirty patients per month that is total of 90 patients were enrolled in the home care program during this period and they were divided into three groups depending on the route of the three home care vans which the society is running. Each of these vans has made on an average 4 visits per day, i.e. total number of patient visits during this period was 720 visits. The total number of enrolled in this program during the period was 47 in July, 40 in August and 42 in September. 

3) Hospice Program- the number of patients who were admitted in the hospice ever since its start in July 2013 has touched 1400 patients. Of these as many as 600 patients have died in our hospice while the remaining has chosen to get discharged after stabilization and spend the last few days in their respective houses. During the 3 month, July to September 2015, the number of patients admitted to Hospice was 170. At the hospice, it was ensured that our staff consisting of doctors, nurses has given proper end of life care to ensure that the patients die with dignity and without pain and suffering. Our ambulance which is used to transport the dead bodies has made 60 trips for ferrying the dead bodies to their respective homes. All these patients and their attendants were also free shelter and food at the hospice. 

 4) Chevella Outreach Program- The 30 villages in Chevella madal in Ranga Reddy District, Telangana State which have been identified for the implementation of this program were visited by our volunteers, doctors, nurses, physiotherapists and social workers 4 times a month, i.e 12 times during the above period a part from the daily visits done by the village coordinators to identify the patients who are in need of palliative care in each village. The total number of patients who were treated was 20 patients during each visit, i.e 240 patients during this period. 

The amount spent during this period was Rupees 3.5 lakhs for hospice /month and Rs. 2 lakhs for the Home care and Rs. 50,000 for Chevella program. About Rs. 6 lacs /month which is equilent to 18 lacs during the 3 months period. This was met by donations raised from philanthropists, institutional donors apart from donations received through global giving site.

It may be appreciated that, it is extremely difficult to numerically quantify and report on the programs which our society is running for the care of end stage cancer patients. Each patients and their care givers story is unique and needs to be addressed in a very sensitive and holistic approach. There is no common formula that can be applied while providing palliative and end of life care to terminally ill patients suffering from Cancer and other incurable diseases. The effort required cannot be quantified. The above figures are at best indicative of the large number of patients who need palliative and end of life care. A good measure of assessment of our efforts in this field is the feedback which we get from our patients and their caregivers. We therefore, have care giver meetings at the hospice and encourage our staff visiting the homes to get a feed back in order to constantly improve our services. 

Links:

• Film Actor Sri. Nagarjuna Akkineni talking about Palliative Care