Palliative home care — the Calicut experience

Abstract

A three-year-old palliative care unit in Calicut, in the south Indian state of Kerala, started a home care service in June 1996. This paper reviews the first year of operation of the service; in this period 340 home visits were made. The service aims to deliver palliative care to the patients who are unable to reach the hospital, to empower patients to care for themselves and to empower the family to care for patients. One doctor and a few trained volunteers form the team. In addition to control of physical symptoms and emotional support, the home visits permitted minor procedures including nasogastric intubation, catheterization of bladder, dressing of wounds and intravenous fluid therapy. In some cases, the visits helped to change the attitude of families towards the patients - for example, allaying fear of contagion. In some instances, the visits changed the attitude of the neighbourhood towards the patient for the better. In spite of problems like the distances involved and bad roads, the experience of this team shows that a home care system is possible and essential for delivery of palliative care in India.