Palliative Care Jan – June 2005

January 2005 opened with 55 patients receiving Palliative Care. Of these 55 patients, 33 died in the first six months of the year.  These were primarily Cancer patients, only seven were suffering from HIV/AIDS.  One of our longest staying patients, Emmanuel, who came to us in 2001 with Cancer of the Prostrate died in June.  At our last visit to his home he proudly told us that he and his wife of many years had been married by the Parish Priest.  We rejoiced with him, knowing that this important step was what Kubler-Ross would have called “unfinished business”.  Over the years we had seen Emmanuel decline slowly.  In the beginning he was able to ride his bicycle to the treatment centre to collect his medicines.  But as time went on, he became less and less mobile.  At the time of his death he was bed-ridden but as all though his illness, he was pain free.  We were saddened to see him go as he and his family had become good friends.

We also rejoiced with another couple as they wed.  Charles, a young man of 35, was referred to us with Cancer of the Penis.  His condition at the time of referral was dreadful.  His physical condition was only part of his problem.  Charles and his wife and three children were in a house that was literally falling down.  When we assessed his situation we decided that we would have to find funds to build them a house. But when asked what they would like us to do for them, Charles said that he and his wife wanted to marry!  On our last visit to Charles and his family in their new home, they  proudly showed us their wedding rings. Charles only lived seven months after his referral but we know that he died peacefully, pain free and knowing that his wife and children now had a sturdy house to live in.

In the first six months of the year forty-three new patients were registered.  Twenty one of these patients were suffering from Cancer.  It was noticeable that several of these patients had been referred by our Community Volunteers. At the end of 2004, our Palliative Care nurses had given workshops to the community volunteers about palliative care and the conditions that we treated.  One volunteer told us of a neighbour, a woman of 68 with a long-standing breast cancer.  The cancer was a fungating mass and the woman was in severe pain, yet she had never sought medical help as she thought that nothing could be done.  How fortunate she was that she lived near our community volunteer.  Of the Cancer patients that were newly referred, the most common diagnosis was Cancer of the Cervix. Eight women had this diagnosis.

Cancer of the cervix is often seen in women who are HIV positive, but many of the cases that we see are elderly, HIV negative patients.  With the HIV/AIDS patients the most common condition requiring pain relief was Kaposi’s Sarcoma. We have found sadly that even with the advent of Anti-retroviral therapy, KS remains a big problem and seldom responds to ART.

We continue to receive referrals from our own Home Care Nurses as well as local hospitals and doctors.  Since we try to care fore the “whole” patient, we continue to offer social support with the provision of basic necessities like soap and bedding.  Most patients are in need of supplementary food as well and we try to help in that area too. Funds are also delegated for house repairs and building houses if necessary. 

Palliative Care  Jan – June 2005