Home-based Palliative Care: An Evolving care Model for End-of-life care (EOLC) Patients (Opinion)

The goal of end-of-life care (EOLC) is to alleviate pain and provide comfort and peaceful dying to patients suffering from a terminal or life-limiting illness. It is patient-centred care that emphasizes giving comfort to patients with respect to patient’s values, experiences, and needs, and coordination of care is planned accordingly no matter how terminal the ailment is. Perhaps EOLC is intended to improve the patient’s quality of life.

According to Mulji and Sachwani (2017), even though Pakistan has a huge burden of disease, the concept of EOLC is still emerging in Pakistan. The country’s recognition and support for palliative care services are slowly expanding. EOLC is only provided by a small number of organizations in Pakistan and is insufficient to meet the nation’s needs.

In Pakistan, the prevalence of chronic diseases is relatively high. By 2025, the burden of non-communicable diseases such as cancer, diabetes mellitus, and mental health issues will account for 3.9 million of all deaths in Pakistan among those aged 30 to 69 (Kashif, 2022). In these circumstances, palliative care must be developed and integrated into health care systems, along with its awareness among the general population.

Hospital-based palliative care and home-based palliative care are two types of palliative care models. When compared, it was identified that the provision of services in the patient’s home has been thought to provide several advantages, including lower treatment costs, a decrease in hospital readmissions, improved quality of life, higher survival rates, a greater sense of comfort and security, and mood enhancement for patients and their families (Shaikh et al., 2023). A hospital is a stressful and contaminated environment where every other person is considered a host and every next door can be infectious.

A person suffering from an illness is immune-compromised, and if going through a terminal illness, it can be more dangerous to bring him or her into the environment, which is not only depressing but can also serve as a potential harm. According to the literature, it is suggested that one should not focus on protracting life if the aggressive treatment only adds up to discomfort and suffering.
Instead, initiating a timely plan for palliative care is significant (Tark et al., 2020). Literature also highlights that hospitalized patients in need of EOLC often live most of their terminal days in hospitals without family and loved ones (Kahveci et al., 2020).

A home-based palliative care framework is considered a key model for those with a life-limiting diagnosis. Unfortunately, it is still not in practice as much as it is needed. The EOLC in a home-based environment is still quite new and has a long way to go. For future implications, awareness needs to be promoted within the communities, which can help them to seek palliative care timely and health professionals to plan it timely, which might not change the outcome but will help a great deal towards the journey of a dying patient and the family.

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