World Hospice and Palliative Care Day 2020

“My Care, My Comfort”

Based on the theme of World Hospice and Palliative Care Day 2020, Palliative Care: it’s “My Care, My Comfort”, Dr. Lulu Mathews shares a story with our readers.

 
Dr. Lulu Mathews
Program Director, Academics,
Institute of Palliative Medicine,
Kozhikode, Kerala.
Email: lulumathews@gmail.com

Palliative Care, Chacko’s Comfort

Can I have an omelette for lunch? This, coming from 58 year old Chacko, Carcinoma Stomach, progressive disease, complete intestinal obstruction, really took me by surprise. He had been referred from the adjoining Medical College for terminal care. When he developed feculent vomiting we initiated him on continuous Ryles tube aspiration*. There was no other way. He was quite sick, we did not expect him to go beyond a week. We allowed him to have Omelette, he took 2-3 mouthfuls, tasting it, chewing it before swallowing it. This made him very happy, happier was his wife to see him relishing his food. But unknown to him, the food promptly came back from his stomach and got collected in the Gastric aspirate bag. The next day, he wanted Chicken Biriyani which too was given to him.

As if on an intuition, he requested for discharge. He had a PC nurse Anna as his neighbour. Anna agreed to care for him, and also administer the drugs including 4 hourly Injection Morphine.

4-5 days passed by, Chacko was doing reasonably well. Anna used to give us daily report. Then she informed us that Chacko very badly wanted to attend his son’s marriage which was scheduled after 2 months. Anna took up the responsibility, met the son’s would be in-laws and explained about Chacko’s wish .They agreed for wedding preponement. She also met the Catholic Bishop and got his permission to overcome the three Bans to be read out in the Parish church at weekly intervals (that would normally mean marriage after 3 weeks).

Two days later on a Thursday, Chacko called me from his Parish church. He was attending his son’ wedding. He sounded very weak but told he was so happy that he was attending this wedding. Two days later, Saturday, Chacko left us after spending 2 days with his son and daughter in law.

Now my thoughts on this World Palliative Care Day

  • If Chacko were in a conventional hospital setting, would he even have ventured to ask for an Omlette? Even if he had asked, would he be allowed to have Omlette and Chicken Biriyani?
  • If it were not for a robust PC set up, with a sincere nurse , would he have been discharged on Continuous RT aspiration and 4 hourly Injection Morphine ?
  • If it were not for a PC Nurse who knew Chacko as a person and not as a case of Carcinoma stomach, would he have attended his son’s preponed wedding?
  • If it were not for our Institute’s belief in the PC nurse, would she have had the courage to do all this single handedly with telephonic instructions from us.

So the moral from Chacko’s story is this

  • Palliative Care for all patients at the place of their choice
  • Try your level best to help the patients achieve their wishes.
  • Empower the Palliative Care nurses

*Ryles Tube aspiration: A tube inserted into the stomach through the nostrils to remove the contents in the stomach.

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