Palliative care is as important as drugs, fluids and ventilators, especially for the elderly and frail and those with underlying serious illness who are most at risk from the COVID-19 pandemic. Palliative care caters to patients with cancers, chronic lung disorders, heart disease, AIDS, Alzheimer’s and a host of other diseases. Symptom management and psychological and social and spiritual support are provided.
“The corona virus presents a severe acute care challenge of unknown dimension and duration in which thousands fall sick and many die. The healthcare systems and professionals are stressed and overburdened. In this scenario we may feel palliative care is not important but I feel it has a stellar role to play,” says Dr Aggy Valentine, Senior consultant in Anaesthesiology, General Hospital, Thiruvananthapuram.
The elderly, frail and those with underlying serious illness are in fact palliative care’s core patient population. The death rate from novel coronavirus is very high in the elderly. Here palliative care can manage symptoms, ensure comfort in dying and can support families, says Dr Aggy, who has several years’ experience in palliative care.
An acute infection like COVID-19 pushes the elderly patient rapidly downhill.They need more care, she points out.
“When resources are stretched elderly patients with end-stage diseases may not be given priority for ICU care. Here palliative care can step in,” she says.
If ventilators and ICU beds are in short supply, hospitals will triage cases and such patients can be offered palliative care. Family and friends may be prohibited from visiting the acutely ill. Palliative care workers can visit them and offer solace. Even nurses and physicians may suffer from grief, frustration and moral distress in pandemic times. Palliative care can provide them spiritual care and team support, she explains.
On the importance of practical steps that need to be taken, she says practical steps ensure prompt delivery of drugs. Many calls can be attended over telephone. They can help prioritise needs. Patients requiring high-care needs can be monitored via telemedicine. Video calls can support patients at home.
Palliative care can be started at any stage of the illness even as soon as one receives a diagnosis.
“You don’t have to wait till the disease has reached an advanced stage or when one is at the final months of life. The earlier it is started the better it is palliative care does not mean death. Though it serves many with terminal illness it can also help patients stay on track and achieve their healthcare goals,” contends Dr Aggy.