Even a safety pin can palliate!
On July 14 and 15, 2018, Vyshnavi (Project Officer, Pallium India) and I visited Dr Zachariah Mar Theophilos Memorial Palliative Care Unit at Thadakam, Coimbatore, Tamil Nadu, to observe the services they provide and to determine how to assist them.
Thadakam is about an hour away from Coimbatore town; a calm space in the middle of the forest and the Sahyadri. On our way to Thadakam, I heard Dr Ani repeatedly warning Shaji, who was driving the car, about elephants which emerge from the forest at night. Our rooms were so cool we did not even need the fan.
Dr Ani is an ENT specialist from Ernakulam and a disciple of Dr Zachariah Mar Theophilos who was quite known for his humanitarian works. In his fond memory, she initiated Dr Zachariah Mar Theophilos Memorial Palliative Care Unit at Thadakam, about a year ago. Dr Ani regularly travels from Ernakulam to Coimbatore to take care of the patients. The team in Bishop Walsh Memorial Hospital supports her in all possible ways in this endeavor.
The next morning, we started early for home care with Dr Ani, Shaji, a volunteer and a nurse.
The first house we visited was in 2 km radius but it was hard to find even any teashops nearby. There was a woman ironing clothes with traditional iron box outside the house. Seeing us, she called her mother-in-law. Inside the house, we saw her 83 year old father-in-law lying on a bed, unable to move himself but conscious and oriented. After listening to them, we suggested the use of water bed to prevent bed sores. Fortunately, Reena, the volunteer who always accompanied this team could arrange water bed the very next day. It was evident that these parents were worried their children were suffering because of their illness. For some reason, they were not receiving elderly pension and that added to their problems.
After giving him medicines, Dr Ani asked the man if he wanted anything. We all smiled when he replied that he wanted fruit juice.
We moved on to the next house. By this time, Shaji had bought some breakfast which we gave to the woman who was seated on the floor of the house. She was struggling to fix her blouse with a safety pin. We helped her fix her dress with our safety pin, as Dr Ani said, “please give her a pin; that is palliative care now.” This mother in her early 70s has to crawl on the floor to move. She had femur fracture, after a fall. One of her sons gives her food.
Finally, Shaji managed to find a shop from where we had strong tea. Almost all the patients we visited on that day were elderly, some even 100 years old, in similar conditions. Some of them found it difficult to reach their bathrooms which were commonly built outside, at a distance from the house. In addition to medicines, some of them were given rice, pillows, sheets, and a lot of love and time to be listened to.
We saw a polio-afflicted middle aged woman who could walk only with support, who said that she just wanted to sit in her home and does not want to go out to see anything. Another patient was a middle aged man, who cried like anything when he saw us. He sat in a wheelchair and could not move his limbs. His wife and her parents took care of him. Though regular physiotherapy was improving his condition, they were not able to afford it. The team then decided to arrange regular physiotherapy for this patient and some training for his wife to earn a living.
Let me emphasize here that most of these patients are bed-bound and home care is the only solution we can offer them. I realized the importance of home care after visiting these patients who otherwise would have been ignored due to accessibility, affordability and availability.
We owe a lot to Dr Zachariah Mar Theophilos Memorial Palliative Care Unit, Dr Ani, Shaji, Reena and the nurse for their incredible work in helping the patients who would have left this world suffering needlessly, if not for these caring souls.