Palliative care: Live and let live

Margaret Ningthoukhongjam *

Humans are mortal and death is inevitable. Whether we take the long way or the short cut, our sole destination remains the same. How we choose and which one we choose is predestined, most importantly, by our fate and our idea of responding to it. Life is unpredictable and living points / discloses the tentative thread that binds one's life with death. Since time immemorial, hope continues to be the greatest medicine that strengthens this thread and prolongs one's journey. Our advanced and triumphant medical system and culture are also the basic precursors which are instrumental in culturing hope.

Our fate I would say, works in its own unique way and it alters its role individual wise. Fate makes life unpredictable. Let's take the example of a woman who had never smoked a cigarette or had never lived with a smoker throughout her life and still suffers from lung cancer, while a chain smoker leads a healthy life without any problems.

Similarly, some people suffer from severe illness which can be cured by undergoing proper medical treatments and surgeries while some suffer from chronic incurable illness like cancer, AIDS and mental illness like Schizophrenia, Multiple personality disorder, depression etc, Paralysis of limbs, mutilation memory loss due to accidents may also occur.

Either way suffering is painful and exhausting. Life becomes miserable for them and their families. Hope is deprived as living becomes meaningless and they start doubting their existence. Let us also consider the live of elderly people. They are the most unfortunate as they are at the most tender stage of life. Their bodies are 80 -90% degraded and are prone to certain physical as well as mental illness. Love and care is the most essential to allow them live their remaining days the way they like and experience a pain free death with no regrets is their only desire.

However, it is easy to provide care and motivation to patients who are suffering from illness which can be cured but when it comes to those who are terminally ill and are suffering from incurable illness, the process demands a static and a very delicate approach. This new level of care is collectively known as palliative care – providing care, help and motivation to dying and bedridden people socially, physically, mentally, financially and spiritually so that they can cherish their remaining last days of their life. All these aspects of living are mandatory for the psychological and physical well being of a terminally ill or bedridden person and thus improve their quality of life.

Palliative care is a genuine approach which provides love, care, relief, motivation and help to depressed and dying people while rejuvenating their hope once again. Palliative care volunteers ignite the life of these people by putting themselves in their shoes and taking part in their despair. They take the patients' problems overhead and directly reach out to their hearts. Their main purpose is to make the other person feel loved and contented and to walk hand in hand at all times.

Palliative care givers should be honest, optimistic, trustworthy, patient, caring, loving, hardworking, understanding, empathetic, alert, should possess good communication skills, be tactful and loyal. They should be responsible, diligent, very firm with their objectives and avoid distraction due to factors like sex, religion, race, caste, politics, etc, Impartiality and altruism are also important determiners. To extend support, spread love and guarantee happiness is a divine act and this approach is patient centered and not disease / problem centered.

Our instinct to survive works in a miraculous yet, simple way and it is this force that drives us to strive for the same. Darwin's "Survival of the fittest" theory explains about the various curriculums that promote a person's ability to adopt to the ever changing surroundings and comforts him to act accordingly. He observes, interprets, thinks, interacts, evaluates and responds in the most reliable way.

Like I mentioned earlier, people choose different ways and get into hard and long fights to avoid the obvious result. They sometimes, put their life at stake and trust the erstwhile medical system. But "death" being the ultimate enemy, it will knock at each door sooner or later. The long way might give you more time and meanwhile make you weaker and weaker, unconscious about your very existence but still you will breathe and still survive. Appreciating life and being conscientious about it implies living.

Literally, 'to live' and 'to survive' are synonymous but psychologically, there exists a fine differentiation between these two prospects. Subjectively, 'to survive' is to avoid death at any cost while 'to live' is to inhale the real essence of life and embrace death as a part of it.

According to Maslow's need hierarchy, the five basic needs required for living are physical needs, safety needs, social needs, need for self – esteem and self – actualization. These deficiency needs and growth needs are the main sources of motivation and are fundamental for a person to live.

Palliative care givers aim on providing all these needs and at the same time, motivating and encouraging them through thick and thin. Moreover, the volunteers are developed spiritually and psychologically. They are trained and preordained to face the reality of life to be compassionate, be objective and subjective when required, be faithful and enhance their prosocial behavior. Their outlook and views of life becomes more realistic.

The working of palliative care is easily accessible if the system is well – established. Herein, trained doctors nurses along with volunteers visit the patient's palace; study their problems and provide quality help and care. This system was first established in Kerala 23 years ago and since then, has taken a firm root. At present, there are more than 1000 Palliative Care centers in Kerala.

As part of the plan, Manipur has come foreward and the Palliative Care Society, Imphal has been founded on 16th April, 2015. Many doctors, nurses, other professionals, teachers and more than 100 students from different colleges have enrolled as volunteers. They are well trained personnel. However, regular training programmes and meetings have been organized for new volunteers.

The Palliative Care Society, Imphal has adopted Thangmeiband Assembly Constituency for its pilot project in Manipur and started home visit based Palliative Care. The society has taken a step closer to fulfilling its aim of extending unconditional support and care to hate inflicted souls. Various awareness programme, fund raising programmes and regular discussions have been organized for the sole aim of expanding and strengthening the society's objectives.

The energetic and audacious volunteers / workers of the society has marched a cycle rally on 20th September 2015 and a walk on world tourism day for fund drive and awareness

The backbone of this system is the student volunteers and the success of the project wholly lies in the hands of the media, the community, their co – operation and most importantly, the zeal and enthusiasm of the volunteers. Such a project is a humane approach; is "one of a kind "and a 'boon' in disguise for the people. Their main objective is to enlarge their project; sensitize people and help as many patients, requiring Palliative Care as possible. The meaning of life is well experienced and defined through this process.

On November 19 and 20, 2015 Palliative Care Society, Imphal organized an International Conference on Palliative Care at Imphal which attracted more than 500 delegates from all walks of life. Several experts on Palliative Care from within the country and abroad deliberated during the conference. Such conferences will indeed help widen the awareness among our public.

Therefore, Palliative Care allows a person to live and also helps others to live. The Palliative Society is a society for the society. It is impossible to move on without the support and consent of the people. The society is by far the greatest contributor for success. This is the genuine call for the society by the society. Palliative Care is at the mercy of the society and it is our duty as a social being to feel responsible and join hands this very moment.