Palliative Care –The need of the day
By: NARAYANAN KIZHUMUNDAYUR
Palliative care has become an increasingly critical aspect of healthcare in today’s world, where medical advancements have enabled longer lifespans but have not always ensured better quality of life.
As diseases become more chronic in nature, and populations grow older, the emphasis is gradually shifting from merely curing illness to truly caring for the individual. Palliative care stands at this vital intersection – it is a specialized, holistic approach to care that focuses on relieving the suffering of patients with life-limiting or serious illnesses.
Unlike curative treatment, which seeks to eliminate disease, palliative care is centered on the alleviation of pain, management of symptoms, and the provision of emotional, social, and spiritual support. Its goal is not to hasten or postpone death but to help patients live as actively and comfortably as possible, regardless of the stage of their illness.
In earlier times, families and communities provided natural support systems for those nearing the end of life. People died at home, surrounded by loved ones, and care was often instinctively compassionate, though medically limited.
However, with the rapid medicalization of healthcare, death gradually shifted into the domain of hospitals, often turning into a lonely, clinical, and undignified process. Advanced technologies, ventilators, ICUs, and aggressive treatments have saved countless lives – but in many cases, especially in terminal illnesses, they only prolong suffering.
Patients battling diseases like advanced cancer, end-stage organ failure, dementia, or progressive neurological disorders often endure not just physical pain but psychological trauma, loneliness, and a profound loss of dignity. This is where palliative care becomes a moral imperative – it steps in not with the promise of cure, but with the promise of comfort, compassion, and dignity.
In countries like India, the need for palliative care is both vast and urgent. With over a million new cancer cases reported annually, and rising numbers of chronic conditions like kidney failure, stroke, and Alzheimer’s disease, the demand for long-term and end-of-life care is growing. Yet access to quality palliative care remains abysmally low. According to global health statistics, less than 3% of those who need palliative care in India actually receive it. This is due to a combination of factors: lack of awareness among patients and healthcare providers, limited number of trained palliative care professionals, inadequate infrastructure, and societal taboos around death and dying.
Pain relief – one of the most basic tenets of palliative care – is itself a neglected area, with regulatory barriers making access to essential medications like morphine difficult in many parts of the country. The result is that countless individuals die in agony, not because their pain cannot be managed, but because it is not even acknowledged.
One of the gravest misunderstandings about palliative care is that it signals the end of hope. On the contrary, palliative care is about redefining hope – it does not promise the eradication of illness, but it does offer hope for better days, for peaceful nights, for meaningful conversations, for moments of joy, reflection, and reconciliation.
When introduced early, even alongside curative treatments, palliative care improves not only the quality of life but also the emotional resilience of patients and families. It fosters shared decision-making, encourages advanced care planning, and helps patients prioritize what truly matters to them in the time they have left. It is care that listens, that respects choices, that allows space for spiritual questions, and that honors the deep human need for connection and meaning.
Families too are profoundly impacted by serious illness, often becoming untrained caregivers overnight. They face anxiety, exhaustion, guilt, and anticipatory grief. Palliative care recognizes the family as a unit of care, offering them counselling, guidance, and support so they can navigate this difficult journey with strength and understanding. It helps reduce caregiver burnout, provides bereavement support after loss, and fosters a culture where death is not seen as failure, but as a natural part of life deserving of dignity and grace.
The recent COVID-19 pandemic starkly highlighted the gaps in healthcare systems, especially in the realm of end-of-life care. With hospitals overwhelmed, families separated from loved ones, and many dying in isolation, the value of palliative care became all the more evident.
It demonstrated the need for humane, person-centered care that goes beyond machines and medicines – care that brings presence, comfort, and solace when cure is no longer possible. It reminded the world that no patient should have to die in pain or fear, and no family should be left to grieve alone.
To integrate palliative care into the mainstream, a multi-pronged approach is needed. Policy changes must prioritize it as a part of primary healthcare. Medical and nursing education must include training in palliative principles. Healthcare providers must be sensitized to look beyond disease and see the person behind the patient. Community-based models should be encouraged, with trained volunteers and home-care services extending support to remote and underserved areas. Above all, a cultural change is needed – one that accepts death not as a taboo, but as a universal human reality, and ensures that when it arrives, it does so peacefully, painlessly, and with dignity.
In the end, palliative care is not just a medical specialty – it is a philosophy, a humane approach that values life in all its fragility. It affirms that even when nothing more can be done to cure, much can still be done to care. It speaks to our deepest values of compassion, respect, empathy, and love. It is a mirror that shows us what it means to be truly human.
As we move forward into a future marked by increasing longevity and complexity of illness, the urgent call of our time is clear: to ensure that every individual, regardless of age, wealth, or diagnosis, has the right to live – and to die – with dignity. Palliative care is no longer a luxury. It is a necessity. It is, unquestionably, the need of the day.
(The author hails from Kerala and is an accounts professional)
