End of life care and family issues and their concerned at palliative care at bhaktapur cancer hospital
Objectives: The objective of the study was to find out the family issues and their concerns about the end of life care planning at palliative care unit admitted the patient.
Method: A respective study was carried out among the family members of advanced-stage cancer patients who were admitted to the palliative care unit from 1st Jan to Dec 31st, 2017. 70 family counselling forms which include patient’s demography, final diagnosis with stage, and patients knowledge about their own disease, present patients palliative performance status, relevant family issues from nearest family members and planning of end of life care.
Result: The study revealed the majority of patients were male. 70% have PPS <50% (80%) lies between 50 to 88 years with stage IV disease (80%). Most of them CA lung 80, Ca Stomach 30, Ca breast 36 Ca gallbladder 24, Ca head and neck 24, Ca ovary 16, Ca colon 24, Ca pancreas18, sarcoma 24. 60% of family members prefer home for final hours of life and 60% want no active treatment and allow natural death. 62% patients did not know their disease as cancer due to family barriers, 70% of the family member thought to know their malignancy with increase their anxiety and hasten death.
Conclusion: Majority of the patients 62% did not know their disease due to the familial barrier, 2/3 of the families had many issues which need to be addressed financially, socially as well as emotionally, most of them want to take back to own home at last hour of life. As there are no good facilities to take care at the periphery, home hospices are the special need for patients care and bereavements.