JOIN USA LITTLE COMFORT Cancer is a struggle not only for those who are afflicted with it, but also their family. One of the ways to make it less traumatic is opting for certain treatment procedures at home, reckons Dr Gaurav Thukral
Rakesh Chandran is a retired bureaucrat whose wife was diagnosed with breast cancer two months ago. Their only son lives in the USA. On getting to know about his mother’s ailment, he came to India, only to return in a week due to an urgent work assignment. Rakesh’s wife developed severe complications after her cancer surgery and had to be kept in Intensive Care Unit (ICU) for three months. It was extremely difficult for 76-year-old Rakesh to take care of her all by himself.
Like Rakesh, 32-year-old Chitra Shah was devastated when she came to know that her husband was suffering from lung cancer. Chitra found it difficult to manage the situation. She alone had to look after her husband at the time of surgery. She had to drive him to a hospital that was 40 km from their home and for regular chemotherapy sessions thereafter. She quit her job in order to be by her husband’s side and take care of her in-laws and two-year-old kid. Financial crunch put additional pressure on Chitra.
Rakesh figures that had there been a way to have an ICU set up at home, it would have given him some relief, while a homecare facility for chemotherapy and related procedures is something Chitra longs for. What Chitra and Rakesh are looking for seem to be an unreal thing to those who are waiting for the same facilities. Many who had been in a similar situation like Rakesh and Chitra can relate to them. While seeing their loved one grapple with the pain and trauma is unbearable for family members, taking them to the hospital for chemotherapy and other procedures, caring for them at home and providing them the emotional support they need also takes a toll on them.
Domestic care
It would surprise you to know that there are now facilities available by means of which cancer can be cared for at home. Such facilities are now being provided by homecare service providers who extend comprehensive and cohesive cancer treatment and care to the comfortable confines of one’s home. They provide all types of chemotherapy to cancer patients. They employ nurses who are specialised to serve cancer patients and adept at performing adjuvant therapy administration, a procedure that requires expertise to inject a drug that increases the potential of anti-cancer treatment.
The nurses are also skilled at PICC line dressing, chemo port flush and neutropenic care. While PICC line dressing is a dressing that is done to prevent any wounds due to continuous chemotherapy sessions, chemo port flush is a procedure in which a port is used for chemotherapy to avoid any vein puncture. This port has to be flushed time and again to avoid any blockage in it. Also, in the process of radiation, healthy white blood cells of the body get killed, lowering the immunity and leading to neutropenia.
Oncological nurses are also adept at symptomatic management and pain relief management. The nurses are made to undergo specialised training in palliative (end of life) care, particularly to provide counselling and support to patients, resulting into their quicker recovery.
There are several reasons for which people prefer homecare to hospital care for cancer patients. One of the many is peace of mind. Just the feeling of being home is comforting and expedites the patients’ recovery, as being around the family and friends boosts their morale. The personalised care offered through homecare addresses the unique need of every patient. Longer stay at hospitals lead to huge medical bills, thereby putting enormous pressure on family members. Compared with a hospital stay, homecare is cost effective as it cuts the indirect expenditures. Also, it lets family members resume a normal schedule, leaving their dear ones in trusted hands.
It also helps the doctors to constantly monitor their patients’ condition. By keeping their doctors in the loop, homecare providers ensure medical intervention and supervision to the patient without any interruption. The doctors have complete control over the treatment of the patients. They provide extended reach to the patients’ doctors in conditions where the patients find it difficult to travel to the hospital. Additionally, servicesprovided by them also free doctors at the hospitals, making them available for other patients.
The backbone of some of the premier homecare providers are its highly qualified and registered healthcare professionals. The company hires employees after conducting thorough background checks. A lot of emphasis is put on the nurses’ training. The staff are also made to learn clinical skills such as infection control and life support. Post training, a clinical competency check is conducted to make sure if procedures are performed in accordance with the best practice guidelines or not.
Apart from all this, IT training is imparted to the nurses, who are given a mobile device such as a tablet or a smartphone so that the data captured by them could be sent to the doctors handling the respective cases in real time after the clinical evaluation by the teams at back end. The personalised approach and IT-enabled operations encourage the doctor and patients or their family members to have greater control over the disease and its treatment.
Oncologists in India, too, are finding such services noteworthy, and recommend it to their patients. Cancer patients go through a lot of emotional trauma. It is no less tedious for the patients’ family members. This is where homecare facilities can step in, making life a little easier for them.
(The author is head, medical services, HealthCare at Home)