Care Beyond Cure Cipla Palliative Care and Training Centre 1997-2007A Desperate Need ‘According to the National Cancer Registry Programme of the Indian Council cf Medical Research, there are 200 25, lakh cancer patients inthe country st any given time wrile 710 9 lakh new cancer cases are detected every year. AL a conservative estimate, 70 percent of the cancer patients in India requre palliative care 2s @ majorty of cases are diagnosed al an advanced stage of the disease, resulting in poor sunival and high mortakty rates. Thete is @ desperate need fo broaden the awareness about palliative care and extend its reach. With paliative cate nat yat forming part of medical education. there is also a need to educate and empower medical personnel in this compassionate yet demanding task. Ciplas Palliative Care Gentre has been making concerted elforts to not only care for patients but also to spread the knowledge by informing and trining, ROLE OF PALLIATIVE CARE IN CANCER Cao ‘Treatment continues asiis yo meron symp sn uae Supportive palliative care Toretics pat of pan raysen and ae disreetoid flects o ‘heron eee heute ae Supportive palliative care Toraduce mpact of pan, nausea ana oer clarecsul ede elects of ‘nerapy ‘Treatment stopped asi yields no bane and side "secs are saris Comprehensive pallative car Conta of pan and ‘mpicms; poychologial $20, cultural ane spa stppot ylcalFocused on Life ‘The Palliative Care and Training Centre, Pune was set up in 1997 by the Cipla Cancer and AIDS Foundation. Over the decade, tho Cipla Cantre has cared for 5000 patients and their farilies. It has been following a unique family model of care, where a family member is trained to look alter the patient with confidence at home, Palliative care provides relief from symptoms caused by a disease or its treatment, I aims to imprave the quality “We must al de. ‘But that I can save him from days of torture, that is. What I feel my great and ever new privilege. Pain is @ more teri lord of mankind than ‘even death soll” Dr. Albert Schweitzer Humantaian thecanien,missonayy andes dates ‘at le Nebel ata za TH? of a patient’ lite and provides support to the patient and family during and atter the treatment. Palliative care has a role to play right from diagnosis till bereavement ard beyond, The Centre adopts a holistic approach, treating the person as a whole, It involes symptom and pain management, cares for mental and emotional healt, and caters to spiritual needs,Care at the Centre Most common symptoms reported by cancer pationts who rood palliative care are pain, woaknoss, sleeplessness, loss of appetite, constipation and nausea. The first prority at the Contre isto try and rofave the pain. (Once the pain and other distressing symptoms are under control, the patient isin betier spirits anc! is encouraged to feat normal food, walk around and return to “normal” activties as soon as cossible. Palliative care is not limited to the physical health of the patient. Recreational healing plays an important role in palliative care at the Centre, The art and craft classes and fureled cultural programmes til the patients with positive energy. The meditation sessions relieve stress and recharge patients and care-givers ale,There are facillies for one relative to stay with the patient, The Centre's team trains the relative in the proper care of the patient at home after discharge. All facilities for the patient are fee, including food, medicines and accommodation, The Telative of the patient gats ftee accommodation and subsidised food. Most patients regain a more positive frame ff mind and are ready to return home within a matter of days.Home Care There are times when the family needs a litle respite, lke during examinations. At these times, voluntoors go home and take charge of the patient, Or, the Gentre readmits the pationts and looks aftor ther, til the family is once again ready to cortinue pallative care at home, The patient continues to get free medicines after discharge. On day care days, discharged patients can come back, meat the doctor and take a fresh stock of medicines. They can also meet other patients and take Patt in cultural actvitias. In addition, the Centre's team visits the patients at home, ‘When the inevitable happens, the Centre's team offers bereavement suport. It maxes it litle bit easier for the family members to accept the loss and to get back (0 normal iteOptimising Care Ithas been an instructive decade for the tearn al Cipla Centre, Given the extent of ignorance about palliative cate, it remains a challenge to establish that palliative care Is not just an enckotthe-life option but can co-exist with normal therapeutic techniques. tke radiation anct chemotherapy. By helping to control the side effects palliative care makes it easier for the doctor to optimise therapy. Volunteering Care A dedicated team of volunteers makes a valuable contribution to the centre's endeavour to provide compassionate care to more and more patients. The Cipla Centre is grateful to lis volunteers for ther silent, seliess he/o in ensuring optimum care, notin only in the Centre but also at homes of patients, in many areas. These include: * Organising social, educational, recreational and skill-development programmes for patients and relatives, ** Faciltating day care centre activites. * Helping the home care team with ‘medicine distribution, counselling, data collection, respite care and bereavement support * Holp in conducting training programmes and administrative tasks. Drawing on its experience and the recent advances in pain management, the Centre is constantly exploring ways lo enhance the level of care. As part of this, the Cenlre has set up a physiotherapy clinic equipped with a pneumatic compression machine to treat lymphoedema,Spreading the Word The Centre has been conducting regular courses in palliative care in general and in the specitic aspects of palliative care, ke wound management. Iniially the focus was on training doctors and nurses from government institutions. Now the Cenire encourages participation from practising dactors and family physicians, Declors who train at the Centre are able to provide palliative care for patients and, when more specialised cate is necessary, direct them to the Gentre. The Rugnasahayak (Patient Assistant) Certificate Course of the Yeshwantrao Chavan Maharashtra Open University Wissen mi a) Government | Private | Total Doctors | 149 a7 196 Nurses | 481 114 595 Total 630 161 791 has been @ big draw to boys and girls, especially those {rom the weaker strata of society. Apart from the regular subjects related to basic healt care, the students who complete the course ftom the Centre get additional exposure to palliative care. Once they complete the course, the students can play en important role in medical insittions and also as care- givers at nome.Apatt from training professionals, the Certre particioates in aciiviles conducted by educational and other institutions that provide an opportunity to spread the ‘word about palliative care to one and all, For instance, occasions Ike the World Palliative Cate Day are fully Lllised to take the message of palliative care to as many people as possible, through various community activities ranging from blood donation camps to music programmes. Special workshops are also held to acquaint experienced doctors and nurses with palliativeFeelings When | el il in 2604, the dlegnasis was tat 1 was suffering trom Iymphorra, a type of caricer There was a sweling in the intestine which was creating eating prabiems for ma, | could haidly eat as there vas sale room lef n the stomach for food. The only therapy avaliable was chematherapy of which t was mighty aaa, My chiloren (my wite passed anay in 1994) advised me to gon for homeopathic weatment. At 77 years ‘of age, had seen enough of the world and said OK. The ‘homeopathic trealmont did not work for me. By March 2605, | Jcund myself on the threshold af death. My bod) weight had gone down from 65 ky 10 50 kg. Energy levels ran low I coud harcly walka few steps. At tis stage Ithaught of going to same hospice to spend my ast few days paniesshy 1 got admitted ta the Cis Centre and stayed there for a week or so, The Cipla medication did work, The swelng aid subside. My eating end along with it my energy levels did improve. eft the clinic sith the prescribed medicines in adequate {quantities for a fernight. Al his happened in March 2006 andi I am now writing this in [November 2006-1 have been visting the Cinla ent regularly for checkups and medicines ting the last few months. 1 krow that the Cente would sland by me thraugh the remaining period of my tte and would nat abandon me even when the disease ‘proceeds beyond the ken of pallatve care What a comforting and reassuring thought! Narayan Dixit Ex-Company Secretary Before coming here, 1 was depressed. After entering this Centre, everybody showered love and concem and I felt better Suniti Kelamaker pousenite Iwas directed 10 this centre by my kth and kin with @ lot of hope and assurance. Atter two days of my slay here, 1am glad to place ‘on record that 1 am setuming hame with greater assuran: and hope. 4 thousand thanks 10 this entite team of workers here. No words can express my ‘ratitude. Long lve this centre! Shreepad Purohit Prnciealctcalege My lather was admitted here 10 ‘days ago wiile in alot of pain and discomfort. Today we are taking him and needless to say, he has a grin on tis face. He has regained a bit of his composure and spit, hich is heart warming to see. At ‘our end, we also feel relieved. All this has been possible due to the relentless efforts of the staff of Cipla. 1 would ike to take this ‘moment to thank all the doctors, nurses and helpers. Besides all the good professional services, they look afer patients here like family. son of Sudhakar Daniel Suryawanshi Aavosateea Ua aa Se ae ea Cou eran a lade os ‘nate 00] este setae as mee rn 80 Pi Feyy «Ponce seca 3Our Nightingales This is what we do He sat by the hospital bed of his young sen, who tas ou rom a maeremergeney sung. Drea thoughts ent creeping ato fix mind, "Why had he not called the docior earlier? Why had he not fuspectd ha his sn oubles ere more than 2 stomach ache? Why? Why?" Just then the young boy stitred, opened his eyes and saw his father sitting nearby. The lad stretched out his smali, fevered hand toh lather and sa, “Hdd my hand, Pape; huts 3 much. He ok nis see's hand, the smal boy amiod wea an oid off nto unconsoiousnese again. Then tre father bowed hs heed, closed his eyes and whispered "Hold hare, Gok Tt” This is exactly what we do and are called 0 do at the Cols Cente, Painful eyes look a us mourning lips utter words of hurt, feebie hands are strotchod: The Cipla Palliative Care and IRI ere Ce STE Cas See Trainer Gentes ve whens prayer “Hold her his han, God else huts oe cee ee ea Our Team ‘email into@carebeyondoure.org www.carebeyondcure.org