Palliative care: Key to quality life, yet unknown in Nagaland

‘Dept. requires more manpower, support from govt. and people’
S Henlly Phom
Dimapur, Jan. 16 (EMN): Palliative care is an approach that seeks to improve the quality of life of patients and families facing problems associated with life-threatening illness. The concept and benefits of palliative care—relieving pain without dealing with the cause of the condition—is yet to be fully engaged in Nagaland.

Nagaland has two palliative care centres. They are the department of Palliative Care Doctor at Christian Institute of Health Sciences and Research (CIHSR) in Dimapur inaugurated in May 2013; Palliative Care Centre at the Impur Christian Hospital in Mokokchung district inaugurated on Sept. 28 2017.

The CIHSR’s palliative care centre is led by Dr. Nepuni Athikho; comprises a junior doctor, a trainee Oncologist and a nurse. It is not sufficient as the department requires more nurses which can be possible only through motivation. ‘The notion of palliative care is yet to be known in our society,’ Dr. Athikho told the Eastern Mirror.

Palliative care centres represent three elements: the head representing knowledge, the hand representing work and organisation; the heart, a love component. “For a palliative care, we need people with heart and not just services,” Dr. Athikho explained.

“The palliative care team works together with the patient and primary care giver to improve quality of patient’s life, rehabilitation and activities of daily living. We should provide care and time for a dying man, the same way one would care for a newborn baby.”

Palliative centres are a needed service. Almost every hospital that treats terminally-ill patients   should have palliative care services, the medical practitioner opined. “We want to establish ourselves so that gradually people will come to know of the services and churches can be a good platform to create awareness and it is our aim this year to conduct awareness with involvement of church leaders and NGOs for a better reach,” the doctor said.

Manipur state inaugurated palliative care centres after Nagaland but they are doing much better and ahead of the state with support from the government and students particularly. In terms of policy-making and cooperation, the government’s assistance is needed ‘while we look forward to work with the government and people,’ Dr. Athikho explained.

‘If we have to work for palliative care we need to know that ‘simple pain is total pain’ which consists of physical, social, psychological and spiritual and those combines a ‘total pain’ in a person’ explains Dr. Athikho.

Many doctors focus on pain and not the ‘social pain,’ he lamented. Prevention and relief from suffering by means of early identification and treatment of pain and problems drastically improves the quality of life for patients.

Palliative care centres do not fetch much money but it is more of an act of contribution to the society. One can only hope to receive voluntary support from the people.  If one is aware of palliative care and its services, there would be more people coming forward. People are reluctant to visit the palliative centres because of misconceptions related to such centres as patients or their families associate it with death.

“People should be aware that a Palliative care is termed as specialised medical care for people with serious illnesses. The care would be focussed on relief from the symptoms of stress and the goal would be on improving the quality of life for the patient and their family,” the professional said.

In the process, he pointed out, ‘We should also not forget the senior citizens who are the ones that need palliative care with their physical limitation and since 2017, the CIHSR palliative care centre has been visiting old age homes.’

The centre is synonymous with hospice care but it starts right from the diagnosis of chronic life threatening illnesses. It is actively involved in the management of pain and other distressing symptoms for patients with threatening illness like cancer, chronic kidney disease, heart failures, stroke, elderly patients with dementia to name a few.

“The lack of awareness on palliative care is making patients endure avoidable pain. Nagaland has lots of cancer patients who go out for treatment and come back, and this is the time they need palliative care. There is every need to make available drugs, train doctors and paramedics and create awareness among the general public on the subject,” says the HoD.

Palliative care may be needed by anyone, irrespective of their social and financial status. In the midst of the care, the patient’s family should also be taken into concern as the caregiver goes through ‘compassion fatigue’.

“Our objective is to provide good symptom care while applying the ethical aspect. Palliative care is to improve life through our care and service,” conveys Dr. Athikho said. He opined that it would be encouraging if the centre can receive voluntary services in the form of ‘lay nurse’ and expresses that the department will be willing to provide trainings to NGOs and churches.

Advocacy and awareness is essential where government also becomes supportive, proactive and through this people can also come forward, reiterates Dr. Athikho expressing concern for those who are missing out on the care they need.

This department is unique to CIHSR as it is the first department in Nagaland to provide palliative care to terminally ill patients, said the head of department of Palliative Care at CIHSR.

Services provided by CIHSR’s Palliative Care department

• Palliative care counselling.
• Breaking bad news.
• Pain management.
• End of life care.
• Home palliative care.
• Hospital palliative care.
• Spiritual counselling.
• Minor procedure at home.
• Health education.
• Caregiver education and support.

 OPD– Three days in a week (Monday, Friday and Saturday)

Home-based palliative care– Tuesday and Thursday.

To reach out the CIHSR Palliative care centre one can contact at 8974757629.