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
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 )
Things to be taken...
First aid pack- I.V fluids/Dressings
Drugs-Analgesics-Oral morphine, Tramadol, Dexamethazone,
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
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.
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.