Integration of palliative care with treatment required: Dr Rajagopal

The lack of properly trained palliative staff, both doctors and nurses, and the limited inclusion of palliative care into various medical syllabi becomes a big question with the ambitious project.

KOCHI: The lack of properly trained palliative staff, both doctors and nurses, and the limited inclusion of palliative care into various medical syllabi becomes a big question with the ambitious project to set up a palliative centre at the Ernakulam Medical College with a 100 inpatient capacity getting administrative sanction. “Early integration of palliative care along with disease-specific treatment as advised by the World Health Assembly Resolution of 2014 should happen here.

This would mean every clinical department should have at least some doctors and some nurses with training in palliative care,” said Dr M R Rajagopal, considered to be the father of Indian palliative care and founder of Pallium India. Usually, home care is encouraged in the palliative care sector. However, the government plan would also be viable given that there is enough staff strength. “Inclusion of palliative care in undergraduate medical and nursing education becomes more important as we look at a full-fledged unit for palliative care alone. The Kerala University of Health Sciences has already included it in the curriculum for medical education which is only the first but very essential step.

This would need implementation at various stages of medical and nursing education,” he said. “It would be equally good if the institution has facilities to recruit volunteers and train them in palliative care. Provision for free dispensing of palliative care medicines for poor patients including a system for its delivery in the home setting is also required,” he added. Understanding the concept of palliative care is very important before the plans are made said, Dr Rajagopal. “I would have thought the number of inpatient beds is too large, considering the emphasis is on care at home. But, those who conceived this must have had some specific plans in mind.

However, now that a provision has been made for a large number of inpatient beds, this could be organised into three groups. Some beds could be organised as a short stay ward, mainly for symptom control, respite care, optimisation of treatment and terminal care. A long stay facility for people who do not have an adequate support system in the home setting and a halfway home for people with paralysis,” he added.

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