**3. Importance of home PAL**

#### **3.1 For the patient**

The general principles of Palliative care [9] hold good in case of Home PAL as well, which can be briefly narrated as follows:


But, to achieve those stated above, the patient should be at his peace of mind. Peace of mind comes, when he dwells in a peaceful environment which he is accustomed with since long – his own home. No one wants to die alone. Everybody wants to have his near and dear ones by his side when he is in his death bed [10].

The patient gains more confidence, when he is getting his treatment in his homely environment, where the family members are taking an active part in the process of the therapy.

#### **3.2 For the caregiver**

A person suffering from any chronic critical illness is in a debilitated state. He is not in a position to take care of himself. There comes the role of family members

**33**

*Home Based Palliative Care*

methods of patient care.

the charter needs to be finalized.

tation costs and salary of the Home PAL team.

including referral to higher centers.

center of palliative care.

*DOI: http://dx.doi.org/10.5772/intechopen.98648*

physically, emotionally and financially [11].

is making a major impact in the quality life of the patient.

Logistics will be in term of man, material, money and time.

taken. There is a need for setting up a formal office for the Home PAL.

**4. Things to be done to set up Home PAL**

who come forward to take care of their loved one. Informal care by family members is unique in developing countries like India when compared with the developed world where care giving is usually in the form of paid formal care. But, this transition from being a close relative to a caregiver occurs so quickly that many a times they are not prepared for it. While providing care for their ill loved one, who is in his death bed, caregivers often neglect their own needs. This neglect, over time, comes as a heavy toll on the overall well-being of a caregiver and they feel stressed –

That is the reason why quality of life of patient's families has been included the in the WHO's definition of Palliative care. The family members are at ease, when the patient receives treatment at home. It saves their time and money in traveling to the hospital. They can continue their regular chores and at the same time they can also learn and get trained from the expert team of Home PAL, few of the basic measures of providing palliative care like giving the proper medicine at proper time, providing physical and psychological support when needed. This helps in building confidence among the family caregivers [12]. They feel happy when their work (in the form of patient's care taking) gets recognized and they feel that their minor help

The home-based care services ensure continuity of care for patients and empower the caregiver in the family by teaching them simple and cost effective

Home PAL service can be set up in a quite simple manner. The following are a gist of activities to be performed to set up the home based palliative care [13]. Like any program to be launched, we need to conduct a need base evaluation for the home based palliative care. It will help us to identify the beneficiaries, their requirements and to check if we have enough logistics to support the program.

Once the team or the institute is satisfied with the basic evaluation, competent authorities need to be involved, informed and necessary permissions need to be

Now, the action plan needs to be framed, scanned, verified and edited. This includes the resource based evaluation and what all services should be included in

The Home PAL team needs to be trained efficiently in palliative care. It would be best if a trained nurse and a trained doctor can be included in the team, to begin with. If not, the dedicated team needs to get trained from a dedicated training

The goal of home based palliative care is to involve community volunteers in the team. So, the community volunteers needs to be identified and proper training needs to be undertaken. The resource based evaluation, as described earlier should include the financial requirement for purchasing the necessary supplies, transpor-

In Home PAL, the team needs to travel to the homes of the patients, which will be away from the mother institute or hospital. So, the primary care team or health workers, both government and private, need to be contacted and should be included in the community based Home PAL team. It will help in emergency care and support to the ailing patient, in times, when the Home PAL team will not be available. Also, it will help in quicker diagnosis of any emergency and better management

#### *Home Based Palliative Care DOI: http://dx.doi.org/10.5772/intechopen.98648*

*Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care*

tion of the concept of Home based palliative care (Home PAL) [6].

**2. Understanding 'Home based palliative care' (Home PAL)**

the patients, who are suffering from terminal illnesses.

spiritual and cultural wellbeing to the patent.

well, which can be briefly narrated as follows:

**3. Importance of home PAL**

**3.1 For the patient**

• Independence.

• Planning for the future.

• Caring for their family and carers.

normal process

process of the therapy.

**3.2 For the caregiver**

management. The patient, especially in his end stage of life, is happy to be with his near and dear ones, in his known home environment. This has built up the founda-

Home PAL is a form of palliative care that provides all the basic needs (physical, psychological, and moral) to the patient who is suffering from a chronic debilitating disease like advanced cancer, lung, renal, cardiac disease or may be dementia [7], in their homes or in a homely environment. The Home Pal is provided by a trained multidisciplinary team of doctors, nurses, social workers, physiotherapists, volunteers and others as per the need of the disease progression. The care provided by the team is at par with the standard palliative care practiced in the hospitals, institutions or hospices [8]. Teams of doctors, nurses, social workers and chaplains travel primarily to patients' homes and also to the rehabilitation centres and help in long term care of

The general principles of Palliative care [9] hold good in case of Home PAL as

• Intends neither to hasten nor postpone death. Rather it provides emotional,

• Preparing oneself for the inevitable – death. Affirms life and regards dying as a

• Will enhance quality of life, and may also positively influence the course of illness

But, to achieve those stated above, the patient should be at his peace of mind. Peace of mind comes, when he dwells in a peaceful environment which he is accustomed with since long – his own home. No one wants to die alone. Everybody wants

The patient gains more confidence, when he is getting his treatment in his homely environment, where the family members are taking an active part in the

A person suffering from any chronic critical illness is in a debilitated state. He is not in a position to take care of himself. There comes the role of family members

to have his near and dear ones by his side when he is in his death bed [10].

• Controlling the distressing symptoms of illness, like pain relief, etc.

**32**

who come forward to take care of their loved one. Informal care by family members is unique in developing countries like India when compared with the developed world where care giving is usually in the form of paid formal care. But, this transition from being a close relative to a caregiver occurs so quickly that many a times they are not prepared for it. While providing care for their ill loved one, who is in his death bed, caregivers often neglect their own needs. This neglect, over time, comes as a heavy toll on the overall well-being of a caregiver and they feel stressed – physically, emotionally and financially [11].

That is the reason why quality of life of patient's families has been included the in the WHO's definition of Palliative care. The family members are at ease, when the patient receives treatment at home. It saves their time and money in traveling to the hospital. They can continue their regular chores and at the same time they can also learn and get trained from the expert team of Home PAL, few of the basic measures of providing palliative care like giving the proper medicine at proper time, providing physical and psychological support when needed. This helps in building confidence among the family caregivers [12]. They feel happy when their work (in the form of patient's care taking) gets recognized and they feel that their minor help is making a major impact in the quality life of the patient.

The home-based care services ensure continuity of care for patients and empower the caregiver in the family by teaching them simple and cost effective methods of patient care.
