Dr.Iresh Jayaweera

Home Based Palliative Care Service 
Sri Lankan Overview 


Palliative care facilities are not available for most of  the Terminally ill patients in Sri Lanka. 
Specially for cancer patients. 
When there is no active treatment going on these terminally ill patients are discharged from  the hospital and sent home to be looked after by their relatives. 
Relatives find it difficult to give these patients the required medical and nursing care at homes. 
Some of  them are facing financial difficulties to  an extent where they cant even afford traveling by public transport. 

Cancer care association (CCA) initiated the  “Home based Palliative Care Service” for the first time in Sri Lanka for those needy terminally ill patients free of charge. 

Cancer care is a registered charity Registration Number: L147405. CCA is a Voluntary Social Service/Non-Governmental Organization registered under Voluntary Social Services Organization(Registration & Supervision) Act 31 of 1980 amended by as Act No 08 of 1998. Registration is under The National Secretariat for Non-Governmental Organizations, Ministry of Defense and Urban Development,Government of Sri Lanka. The official Web site of Cancer Care Association www.cancercaresl.com 

Currently it is the only Organization in the country to provide a home based palliative care service. 
This service is available  for those in need in the galle district of southern province with a plan to expand to 
North-Central and Western Provinces of Sri lanka soon.With a population of 1 million galle has 1/20th of country's population with a fast aging demographic picture. 

What we do.... 
Terminally ill cancer patients who need support are identified with the recommendation of the clinical Oncologist/Onco-surgeon and the consent taken for the service. 
Patients clinical/socioeconomic details are recorded while registering for the service. 
Family members are informed prior to the visit and an appointment taken by the team leader 

Palliative Care Team 

All are volunteers 
Medical Officer 
Nursing sister 
Counsellor 
Social worker 
Helper 
On special request: Physiotherapist,Nutritionist,Cleargy 

CCA gets the support... 

Oncology unit of TH-Karapitiya 
Provincial health department 
Grama Niladhari of the area 
Social services department 
Village Temple-Dayaka sabha/Kulangana samithiya. 
Other village committees(Co-operative, Welfare ) 
Other NGO’s 
Volunteers 

Things to be taken... 
First aid pack- I.V fluids/Dressings 
Drugs-Analgesics-Oral morphine, Tramadol, Dexamethazone, 
   Paracetamol,Lactulose,Diazepam,Antibiotics,Anti-emetics,Polybion  etc                                               
NG tubes/Catheter 
Nutrition-High protein/High calorie supplements 
Meditation: small wrist band-(Nawagunawela) 
Spiritual support: Pirith potha 

When the team visits the patient.. 

Holistic approach with Identification of, Physical, Psychological, Spiritual, Social and Financial problems. 
Physical: Symptoms(Complaints) e.g.  Pain,Cough 
Psychological: Sadness, Worries, Fears, Anger 
Social: Problems of the care giver, Issues of the family, Issues of Housing  , Work, Nutrition and Relationships. 
Spiritual: Questions about the meaning of life and death, the need of having a peace of mind 
Financial : Patient may be the bread winner of the family. 
Things to be taken..packed in the box 
Vehicle available.. 

Sorting out identified problems.. 

Physical:Treating-Pain relief,Correct Hydration,Relief constipation.Nursing care and Prescribe drugs. 
Psychological: Listening, Counselling, 
Spiritual:Religeous activities,Chanting of Pirith ,Meditation,Dhamma discussions according to their religeon. 
Social problems: Dry rations,Toilet facilities,Water/Air matress,Wheel chair, Financial : Monetary donations 
Attention to the caregivers: Advises how to face death and . Long duration of caring and outcome. 



How to continue therapy? 
Patients registered for palliative care maintained in a special register in the oncology clinic. And the patients are given a card. 

Once we prescribe a drug e.g. Oral Morphine during a home  visit(usually for 2days only), patients relations can come with the card and get the drugs from the clinic when necessary. 
Identified problems and given solutions properly documented. Palliataive  care register will be updated by the team leader. 
Recommendations  are forwarded to CCA for further assistance e.g. donation of wheel chair etc. 
Feedback from the relatives taken. 
Meeting after each visit to discuss the pro’s and cons and how to improve next time. 
Plan for the next visit for follow up. 

Some statistics... 
Total number of patients registered from 12/10/2011--31 patients 
Out of 31 patients 19 patients reported to be expired by now. 
Number of Second visits-04 
Distance from Karapitiya Oncology Unit- 
Minimum 2 Km to Maximum 70 Km. 

  • Galle, Sri lanka
  • Written by: Dr.Iresh Jayaweera
  • Sunday, 14 October 2012

Contact Us

  34-44 Britannia Street, London, WC1X 9JG, United Kingdom

  by phone: +44(0) 207 520 8200

  by fax: +44(0) 207 278 1021

  by e-mail: info@thewhpca.org

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