Community Palliative Care

We started home visits in the year 2013, to support terminally ill patients and their families by providing advice and medical and nursing care at home. Initially, we started this on a small scale and now, the service is extended to Western, Central, North Central and Southern provinces. We need more nurses to sustain the services as all the nurses are working full time in the hospitals.  They give their time and expertise during their spare time, to which we are grateful. We need more doctors too, as we have only 3 doctors for home visits. Dr. Rohini Ranwala and Dr. Ayoma Perera have been great assets to Sahan Suwa Trust as they give their time amongst a very busy schedule.

Community service in action – A Case Study

By Dr. Chitra Weerakkody

From my own experience, I realised that the availability of and help from a healthcare professional at the time of despair when a loved one is dying is an enormous help and, when provided free of charge, there is nothing comparable.

Mr. K P, 87 yrs old, developed a recurrence of throat cancer when he was referred to Sahan Suwa about 12 months ago. He lived with his daughter, who looked after him well. At the time, he was in severe pain and complained of loss of appetite, difficulty in swallowing and was awake most of the night. One of our nurses visited him to review the problems. It transpired that Mr. K P was miserable as he was unable to carry out his favourite past time, which was tending to a small holding of tea in his garden. It was a leisurely activity as well as an income of which he was very proud.

We treated the pain and the mouth problem; and advised regarding mouth care and nutrition. He started eating and was able to get a good night’s sleep. As a result, he was able to enjoy the outdoor life and gardening. A few months later, he started getting fits and was told that cancer had spread to the brain.  He refused further active treatment and we took over the palliative care in the community, by treating the fits, managing the pain and supporting the family. The daughter understood his wishes and was happy for SS to care for her father. He died peacefully, at home without pain.

Daughter sent this message after his death.  “My father passed away last week. He spent his last months without pain because of your help. May the noble triple gems bless you all” The above story tells us that the pain has to be controlled to improve the quality of life, which is an integral part of palliative care. By doing so we also enabled the patient to undertake activities he enjoys in his last weeks to months, thus improving the quality of life.

Bereavement counselling

A number of relatives and carers benefit by talking to our counsellors following the death of their loved ones.

At this time, we become their friends, by listening and helping them to come to terms with their loss. Some families keep in touch with us for several years. This is especially so for those died in pain and those families who were not aware of the imminent death of their loved ones.

Chemotherapy and Radiotherapy.

We receive many calls from patients who undergo chemo and radiotherapy. They have little or no idea of adverse effects of these treatments and gets very worried when they develop nausea, tiredness or unable to eat rice and curries. They need a listening ear and correct advice to go through this difficult period.

What we do:

• Explain and treat the symptoms of nausea, sore mouth, pain, and fungal infections of the mouth which could occur during treatment.
• Advice regarding nutrition and support for the worried patient and carer.
• Help and support for the worried female, who starts losing scalp hair when treated with certain chemo drugs

Mrs. D, 40 yrs called me from a few years ago. She has had chemo and Radiotherapy for widespread cancer. She has lost most of her hair following chemotherapy. She told me that her daughter is getting married soon and seemed very worried about attending the wedding. She then added, “Doctor, maybe I can wear a headscarf” I explained that she will get her hair back, (as the hair starts growing a few weeks after stopping chemo). But, as the wedding is approaching soon, we were able to get her a hair wig free of charge; through a hair salon. As a result, she was able to attend the most important event of her child with confidence.

Wigs are now given free of charge by “INDIRA cancer care trust.” The office is situated at No 63, Hospital Road, Maharagama.