Dr. Ashok Kumar Badamali, Senior Consultant Cardiac Anaesthesiologist, KIMS delivered a keynote session on “New Dimensions on Palliative Care for Cardiac Patients” at “Convergence-2022”, an international conference co-organised by Vinayak Mission Research Foundation DU, and Vijaya Educational Academy, Chennai.
Dr. Badamali’s futuristic talk focused on skill development and empowerment of paramedics and allied science staff for home-based care of end stage disease patients, with support from various digital health equipment and platforms. The talk was highly appreciated by the audience and other think tanks present at the keynote session. His citation of Maharaja Parikhit’s last seven days of life as end stage pathological situation and discussions of Srimad Bhagbat chapters by various stages as an evidence of spiritual and psychological components of Palliative Care was considered as an eye-opener linkage between science and mythology.
Despite advances in cardiac therapy, heart failure remains a progressive, highly symptomatic and deadly disease that places great demands on patients, caregivers, and healthcare systems. Palliative care is a multidisciplinary approach to care that focuses on communication, shared decision making, and advanced care planning, provides relief from pain and other distress symptoms, integrates psychological and spiritual aspects of care; and offers a support system to help families to cope during illness and bereavement. Palliative has applications across the stages of heart failure, including early in the course of illness, often in conjunction with therapies that are intended to prolong life. However, the incorporation of palliative care into management of heart failure has been suboptimal due to various reasons like: uncertainty in disease trajectory, lack of knowledge, overlay of co-morbidity and frailty, life-saving device with complex trade off, failure to reward communication between healthcare providers and patients, siloed care and availability of limited evidence base.
Palliative care is provided by a team of palliative care doctors, nurses and social workers. They work together with cardiologists to give an extra layer of support. The team has a wide variety of approaches to treating congestive heart failure symptoms. These may include medicines, but not always. Palliative care teams are expertly trained to manage symptoms, side effects and stresses. For example, they may perform highly effective lymphatic drainage. This is a technique for reducing leg swelling and its associated pain, educating the patient about how to stand, sit and lie down to improve their breathing. They will also train the patient and family members, the use of fans, relaxation methods, meditation and breathing exercises to decrease any anxiety or panic that may accompany feelings of breathlessness.