Pain Management Palliative Care of Advanced Malignancy
The aim of palliative care is to enhance the quality of life of the patient and influence the course of the disease in the most positive sense. The care must be initiated as early as possible in the course of the disease in conjunction with other supportive therapies like chemotherapeutic, medical and surgical interventions. Palliative care adapts the philosophy of hospice care and interdisciplinary practice. It applies to all terminally ill patients irrespective of their diagnosis, race, religion, age, gender and culture (National Cancer Control Programme, 2005). Pain relief is the cornerstone of palliative care and enhances the spiritual value of care. Along with pain relief, other symptoms like nausea and vomiting, regional swelling, sleeplessness, gastritis, and constipation must be addressed (Johnson et al, 2006). Quality of life of the patient may be enhanced by encouraging the patient and allowing the patient to indulge in activities which are a source of enjoyment and relaxation for him or her like watching movies and listening to music, by making the patient feels that the patient is yet a much-wanted member in the family and by providing the patient time and space to spend family with her spouse, children, and grandchildren (National Cancer Control Programme, 2005). Education and training must also be delivered to caregivers and family members to increase the psychological and social dysfunctioning of the patient (Keefe et al, 2005). One of the important aspects of providing palliative care is the involvement of the family members and friends in taking decisions pertaining to the patient (National Cancer Control Programme, 2005). Even the patient must be involved and this increases the sense of dignity and self-esteem of the patient. Proper communication and provision of appropriate information to both the patient and her family members before any decision is taken like starting a new intravenous line, changing pain medication or referring to a new consultant increases trust between the patient and the nurses.