Indian doctor adding days to lives of terminally-ill patients

Saving lives is always the priority of a doctor, but for India-born oncologist Ramaswarmy Akhileswaran ensuring that terminally ill patients spend their last days at home with dignity and their families learn to manage end-of-life issue well is the mission of his life.
As a specialist in Radiation Oncology with a leading hospital in Bangalore, Akhileshwaran used to see many patients going through the painful process of radition therapy despite knowing that they wont live.
This motivated him to study palliative care -- a holistic approach to caring for patients going through the last stages of their lives -- in the UK.

After coming back to India, he realised that his skills were not be used properly.
Passionate about palliative care, Akhileswaran, 55, left his job in India and joined HCA, the largest home palliative care provider in Singapore, as its Medical Director in 2001. He assumed the position of CEO in 2007.
Akhileshwaran, who studied at Osmania University, was instrumental in turning HCA around, financially salvaging it from the verge of closure.

He feels that a person who is about to die want to spend his remaining days with his relatives, but on the other hand the family members keep him in hospital and spend a lot of money on him despite knowing that this won't help the patient.

"Most of Singaporeans want to die at home and not in a hospital, yet not many of them eventually do. Some family members keep insisting on sending terminally ill patients to the hospital, and spending a lot of money on nutritional supplements," Akhileswaran said.
"The option of palliative care, which would have improved the quality of the remaining life and reduced suffering, is often ignored. Families end up trying to fight the illness instead," he said.
According to him, the families, with some training, could learn to look after their dying relatives themselves.
"It is not a huge burden, even though some are afraid that they may not be able to handle the patient," he said.

Hospice care aims to meet all needs -- physical, emotional, psychosocial and spiritual -- so as to alleviate suffering and maximise quality of life for patients and their loved ones.
HCA Hospice Care runs three main programmes: Hospice Home Care, Hospice Day Care and Caregiver Training.
Hospice Home Care team --comprising a doctor, nurse, medical social worker and volunteers --goes to patient's home to look after him.
"Home hospice care service is free beacuase we don't want to burden the family who is going through such an emotional trauma and may be running out of money becuase of medical expenses," he said, adding that the service is availbale 24X7.

HCA Hospice Care also run a training programme for patient's families and volunteers so that they can look after a patient at home.
The Day Care centre is for patients who are relatively well and symptom-free. They are transported to and from their homes to the centre for physical and psychosocial rehabilitation.
They spend the day at the centre doing group exercises and other activities. There they are charged a minimal fee depending upon the income of the family.
Akhileshwaran says hospice care is all about adding life to days.