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October 14th 2019

Article by Dr. Hari Mohan

Palliative medicine has made paradigm changes over the years and there is a great need to understand the present concept of palliative medicine as a medical specialty moving away from the charity NGO terminal care hospice approach.

Having said that, in no way is to belittle the terminal care of incurable patients which is still very much a part of palliative care. Many are the conditions where modern medicine can offer no cure but at same time, the period a patient lives in this state has definitely risen from months to years due to advances of medical science.

Medical conditions where palliative care can be used for comfort care are cancer, Alzheimer’s, post amputations pain syndrome, motor neuron disease, Parkinsonism, paraplegics due to spinal trauma. Though no more treatment may be offered, they definitely need medical assistance to tide over many issues connected to their disease or otherwise.

The present palliative medicine does not limit itself to tender care or kind consoling words to the family and patient but it uses the tenets of modern medicine in its technological advances of the current world and applies in a very rational way. It always has the patient as its centrepiece rather than the disease and look for forms of treatment which is limited to symptomatic and supportive care and moves away from futile aggressive life-saving measures.

While science and its skills can be used for the welfare of the patient, palliative care physician restricts such treatment only to the said indication. The ultimate aim is the happiness of the patient and family. Honesty in communication is an important qualification here. The palliative care personnal should also be adept in communications and should be good listeners and include the family as important denominators in the fight against distressing symptoms. Terminal, hospice and home care too form pillars of modern palliative care and the use of volunteers is definitely welcome here. The Kerala model of palliative care is being followed all over the world and this is because of the people’s participation. The aim of this article is to appreciate this, but at the same time to emphasize that medical skills also needs to be used for the best results

The author is associate consultant, Pain and Palliative Care Dept, VPS Lakeshore Hospital, Kochi. (Views expressed are his own.)