Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart related issues. Patients in palliative care may receive medical care for their symptoms, or palliative care at home through professionals such as doctors and nurses, along with the treatment intended to cure the serious illness.

Palliative care is a resource for anyone living with a serious illness, such as Heart Failure, Cancer, Dementia, Parkinson’s disease and others. In addition to improving quality of life and helping with symptoms, palliative care at home help patients understand their choices for medical treatment. The services available through palliative care at home are helpful to older persons having discomfort and disability very late in life.

How Palliative Care Is Provided?

It is provided by a team of trained professionals which includes doctors, nurses, social workers, volunteers, physiotherapist etc. It improves the quality of life of patient who is suffering from serious ailments. A patient gets the best treatment when it’s given at home. When palliative care is provided at home by team of experts it provides sense of safety, privacy, confidentiality and peace of mind. It provides psychological support to the patient [2]

What Issues Are Taken Care With Palliative Care At Home

Patients suffering from chronic debilitating disease like cancer, lung disease, renal issues, cardiac issues, dementia and Alzheimer’s gets palliative care at home or in a homely environment. Senocare had team of doctors, nurses, social workers, volunteer’s,physiotherapist to provide support. Given the rising expense of chronic disease care, it can be difficult for families to maintain treatment in a hospital or hospice. Family members are very important in home-based palliative care. They receive training from the team to master the fundamentals of palliation. Palliative care at home must be integrated into normal home health care services.

Importance Of Home Palliative Care

Home palliative care gives patients with serious diseases and their families physical, emotional, and spiritual assistance, allowing them to live as comfortably and completely as possible in their own homes.

Better quality of life

Symptom management

Home palliative care teams can help patients control their pain, nausea, exhaustion, and other symptoms, allowing them to stay comfortable and engaged in activities they like. Home palliative care provides emotional and spiritual support to patients and their families, assisting them in coping with the hardships of serious illness. Counselling, bereavement support, and spiritual direction are examples of such services.

Improved quality of life for family members

Home palliative care may benefit family members as well, allowing them to spend more time with their loved ones while also lowering the stress and strain of caregiving.

Reduced cost

Reduced hospital admissions

Home palliative care can help patients avoid costly and painful hospital hospitalizations.

Reduced hospital stays

For patients who do require hospitalization, home palliative care can help them heal quicker and return home sooner. Home palliative care can help patients manage their symptoms more effectively, minimizing their dependency on other healthcare services such as emergency department visits and expert appointments.

Things to be done to set up home Palliative care

In countries with limited resources, emphasis on symptom control, especially pain, should be of highest priority, and home-based PC should be integrated into the health-care system [3,4]. Consider the following measures to prepare the home for palliative care

Determining the patient’s requirements

Physical requirements

It’s important to know. the patient’s capacity to move about, do everyday tasks, and manage discomfort.

Emotional needs

Pay attention to the patient’s emotional condition and give resources and assistance.

Spiritual requirements

Recognise and respect the patient’s spiritual beliefs and practises.

Organise prescriptions and supplies

Gather the following medical supplies

Stock up on wound care materials such as bandages, gloves, wipes, and so on.

Safely store medications

Medication should be kept in a safe, organised area away from children and pets. Set up a medicine schedule: Establish a clear and regular drug routine.

Is Palliative Care At Home Beneficial

Patients with serious diseases and their families benefit from palliative care at home. It has the potential to improve quality of life, lower expenses, and raise patient satisfaction.

Here are some of the advantages of receiving palliative treatment at home

Palliative care teams can help patients manage pain, nausea, exhaustion, and other symptoms, allowing them to be comfortable and engaged in activities they like. Palliative care provides emotional and spiritual support to patients and their families, assisting them in coping with the hardships of serious illness. Counselling, bereavement support, and spiritual direction are examples of such services.

Comfort and familiarity

Patients are typically calmer and more comfortable in their own homes, which might enhance their overall well-being.

Improved contact with healthcare professionals

Palliative care teams are accessible to answer questions and give support 24 hours a day, seven days a week, which can help enhance communication with healthcare providers.

Improved interaction with healthcare professionals

Palliative care teams are accessible to answer questions and give support 24 hours a day, seven days a week, which can help enhance communication with healthcare providers.

Palliative Care can support you with

Palliative care at home focuses on providing relief from the symptoms, pain, and stress of serious illness—while allowing the patient to remain in the comfort and familiarity of their own home. It’s centered on improving quality of life patient and their family.

Personal care

Personal care is a critical part of palliative care, especially for patients receiving support at home. It focuses on helping the patient with daily tasks they may no longer be able to manage on their own due to illness, frailty, or disability—while ensuring dignity, comfort, and emotional wellbeing.

What Does Personal Care in Palliative Settings Include?

Basic Hygiene Support

• Bathing or bed baths
• Washing hair and grooming
• Oral care (brushing teeth, mouth rinsing)
• Nail and foot care (if safe)

Toileting and Continence Care

• Assistance with using the toilet or commode
• Incontinence support (changing pads, cleaning)
• Catheter care (if present)

Feeding and Nutrition

• Helping with eating or feeding
• Monitoring food and fluid intake
• Preparing soft, easy-to-swallow meals
• Supporting any feeding tubes if applicable (under nursing supervision)

Mobility Assistance

• Helping the patient get in and out of bed or a chair
• Turning and repositioning to prevent bedsores
• Use of mobility aids (walkers, wheelchairs, hoists)
• Gentle exercise (as appropriate)

Dressing and Undressing

• Choosing comfortable, easy-to-wear clothing
• Ensuring warmth and appropriate attire for weather and comfort

Key Principles in Providing Personal Care

• Dignity and Respect: Always ask for consent, explain what you’re doing, and allow the person as much independence as possible.
• Comfort: Use gentle movements, keep them warm and clean, and avoid unnecessary procedures.
• Privacy: Close doors and curtains, cover the body appropriately during care.
• Routine and Familiarity: Stick to familiar routines whenever possible to reduce stress and confusion (especially in dementia)

Who Provides Personal Care?

• Family caregivers (with or without training)
• Home care aides or personal support workers (PSWs)
• Visiting nurses (especially for more complex medical needs)
• Volunteers (some charities offer trained support volunteers)

Tips for Family Caregivers

• Learn proper techniques from a nurse or palliative care team.
• Use protective equipment (gloves, aprons) for hygiene tasks.
• Know when to ask for help—especially if tasks become emotionally or physically overwhelming.
• Maintain a log of care activities and any changes in the patient’s condition.

Symptom management

Symptom management is at the core of palliative care, aiming to relieve distressing symptoms caused by serious illnesses (like cancer, heart failure, COPD, dementia, etc.)—to improve quality of life.

Here’s a comprehensive overview:
Common Symptoms in Palliative Care & How They Are Managed

Pain Assessment

Use tools like a 0–10 pain scale or facial expression scales.
Treatment:

• Medications: Paracetamol, NSAIDs, opioids (like morphine, fentanyl).
• Non-drug methods: Heat/cold therapy, massage, distraction, TENS, relaxation techniques.
• Nerve blocks or palliative radiotherapy (in cancer cases).

Breathlessness (Dyspnea)

Treatment:

• Low-dose opioids (e.g., morphine) can relieve breathlessness.
• Oxygen (if hypoxic), fan blowing cool air, positioning (sitting upright).
• Medications: bronchodilators, corticosteroids, diuretics (if fluid overload).

Nausea and Vomiting

Causes: Medications, bowel obstruction, liver failure, anxiety.
Treatment

• Antiemetics: metoclopramide, ondansetron, haloperidol.
• Treat underlying cause if possible (e.g., constipation, metabolic imbalance).

Constipation

Treatment:

• Laxatives: stimulant (senna), softener (docusate), osmotic (lactulose).
• Encourage fluid intake (if appropriate), fiber, gentle mobility.

Fatigue

Supportive care:

• Prioritize energy for meaningful activities.
• Light physical activity as tolerated.
• Manage contributing factors (anemia, depression, medications).

Delirium or Confusion

Causes: Infections, medications, organ failure, dehydration.
Treatment:

• Identify and treat underlying cause.
• Medications: low-dose haloperidol or olanzapine.
• Calm, familiar environment; reduce noise and overstimulation.

Anxiety and Depression

• Emotional support: Counseling, talking therapy, spiritual care.
• Medications: SSRIs (for depression), benzodiazepines (short-term anxiety).
• Relaxation techniques: Breathing exercises, mindfulness, music therapy.

Loss of Appetite / Weight Loss (Cachexia)

Approach:

• Avoid forcing food—focus on comfort, not nutrition.
• Small, frequent meals; favorite foods.
• Steroids or appetite stimulants (e.g., megestrol) in select cases.

Mouth Sores / Dry Mouth

Treatment:

• Oral hygiene: soft brushing, mouth rinses.
• Saliva substitutes, sips of water, lip balm.
• Treat underlying infections (e.g., thrush with antifungals).

Principles of Symptom Management in Palliative Care

• Treat the cause when possible, but focus on comfort even if cure isn’t an option.
• Individualized care: What relieves one person may not work for another.
• Regular reassessment: Symptoms can change quickly.

Multidisciplinary approach: Involves doctors, nurses, social workers, chaplains, etc

Administrating management

Palliative care at home involves a comprehensive approach that integrates medical, emotional, logistical, and legal support to ensure patients receive dignified and effective end-of-life care in a familiar Administering environment.

Here’s an overview of the key components involved in managing home-based palliative care:

Medical and Clinical Oversight

• Multidisciplinary Team: A team typically includes a primary care physician, palliative care specialists, nurses, social workers, chaplains, and volunteers. This team collaborates to manage symptoms such as pain, nausea, and fatigue.
• Regular Assessments: Frequent home visits or telehealth consultations ensure that the patient’s condition is monitored and adjustments to the care plan are made as needed.
• Medication Management: Proper administration of medications, including opioids for pain management, and monitoring for side effects are crucial.

Administrative and Logistical Coordination

• Care Plan Development: Creating a personalized care plan that outlines goals, preferred treatments, and emergency protocols.
• Insurance and Funding: Navigating insurance coverage for home care services and exploring government or nonprofit funding options.
• Equipment and Supplies: Arranging for necessary medical equipment (e.g., oxygen tanks, hospital beds) and ensuring a steady supply of medications.

Emotional and Psychological Support

• Counseling Services: Providing access to mental health professionals to support both patients and their families.
• Bereavement Support: Offering grief counseling and support groups for families coping with loss.

Preparing Meal

Meal Ideas

• Breakfast: Oatmeal with honey, mashed bananas, and a glass of full-cream milk
• Lunch: Creamy tomato soup with blended tofu and a side of soft bread
• Dinner: Stewed chicken with mashed sweet potatoes and pureed carrots
• Snacks: Greek yogurt with honey, smoothies, or scrambled eggs

Additional Tips

• Avoid Force-Feeding: Respect the patient’s appetite cues. Forcing food can cause distress and discomfort.
• Monitor for Digestive Issues: Adjust the diet to manage symptoms like constipation or nausea.
• Consult Healthcare Providers: Seek advice from dietitians or healthcare professionals for personalized nutrition plans

Personal Care for Palliative care

Creating a Comfortable and Safe Home Environment

• Ensure Accessibility: Rearrange furniture to create clear pathways, install grab bars in bathrooms, and consider adding ramps if necessary.
• Maintain a Calm Atmosphere: Use soft lighting, minimize noise, and regulate room temperature to create a soothing environment.
• Personalize the Space: Incorporate familiar items like photos, favorite blankets, or cherished books to provide comfort and a sense of normalcy.

Personal Hygiene and Daily Care

• Gentle Bathing: Use warm water and mild soap to cleanse the skin, being gentle to avoid irritation.
• Oral Care: Assist with brushing teeth or using mouthwash to maintain oral hygiene and comfort.
• Skin Protection: Apply moisturizers to prevent dryness and use pressure-relieving equipment to avoid pressure injuries.

Medication and Symptom Management

• Organize Medications: Keep a clear record of prescribed medications, dosages, and schedules to ensure proper administration.
• Monitor Symptoms: Regularly assess for signs of pain, nausea, or other symptoms, and communicate with healthcare providers to adjust care as needed.
• Provide Comfort Measures: Utilize non-pharmacological approaches like gentle massage or aromatherapy to alleviate discomfort.

Emotional and Social Support

• Encourage Expression: Create a safe space for your loved one to share their feelings, fears, and wishes.
• Maintain Social Connections: Facilitate visits or virtual calls with friends and family to combat feelings of isolation.
• Spiritual Care: Respect and support spiritual practices or rituals that are meaningful to your loved one.

Mobility Support for palliative care

Essential Mobility Aids

Wheelchairs

• Manual Wheelchairs: Ideal for patients with some upper body strength.
• Electric Wheelchairs: Suitable for those with limited or no upper body strength.
• Reclining or Tilt-in-Space Wheelchairs: Provide pressure relief and comfort for bedridden patients.

Walkers and Rollators

• Standard Walkers: Offer stability for patients with mild to moderate mobility issues.
• Rollators: Equipped with wheels and brakes, they provide enhanced mobility and support.

Canes and Crutches

• Single-Point Canes: Provide minimal support for patients with slight balance issues.
• Quad Canes: Offer more stability with a broader base.
• Crutches: Assist patients who need to offload weight from a specific leg.

Transfer Aids

• Patient Lifts: Facilitate safe transfers from bed to chair, reducing strain on caregivers.
• Transfer Boards: Enable smooth sliding between surfaces.
• Slide Sheets: Assist in repositioning patients in bed with minimal effort.

Home Modifications for Enhanced Mobility

• Grab Bars and Handrails: Install in bathrooms, hallways, and stairways to provide support.
• Ramps and Stair Lifts: Ensure accessibility for wheelchair users.
• Non-Slip Flooring: Reduce the risk of falls in high-traffic areas.
• Widened Doorways: Accommodate wheelchairs and walkers.

Bathroom and Personal Care Equipment

• Shower Chairs and Bath Benches: Provide safe seating during bathing.
• Raised Toilet Seats: Ease sitting and standing motions.
• Bedside Commodes: Offer convenience for patients with limited mobility.

How you can benefit from palliative care at home?

Comfort and Familiar Environment

• Emotional Ease: Being at home often reduces anxiety and stress compared to hospital settings.
• Better Sleep and Routine: Familiar surroundings support better rest and a normal daily routine.

Personalized Care

• Tailored to Your Needs: Care is designed around your specific symptoms, preferences, and goals.
• One-on-One Attention: You typically receive more individualized support than in a clinical setting.

Palliative care, home health care versus hospice care

What to expect from palliative care at home?

Comprehensive Assessment and Personalized Care Plan

A palliative care team will visit your home to evaluate:

• Your symptoms
• Emotional needs
• Goals of care
• Home environment

They will develop a care plan tailored to your condition, preferences, and values.

Symptom Management

The team will help manage distressing symptoms, such as:

• Pain
• Nausea
• Shortness of breath
• Fatigue

Anxiety or depression

Adjustments are made regularly as your condition changes.

Regular Visits by a Palliative Care Team

Care is provided by a team that may include:

• Doctors and nurse practitioners
• Registered nurses
• Social workers
• Chaplains or spiritual counselors

Frequency of visits depends on your needs (can be weekly, daily, or on-call 24/7).

What services are included with palliative home care?

Medical Care and Symptom Management

• Pain management
• Control of symptoms such as nausea, breathlessness, fatigue, constipation, and insomnia
• Medication management and administration
• Monitoring of vital signs and illness progression

Nursing Services

• Regular visits from registered nurses or nurse practitioners
• Wound care, injections, IV therapy, catheter care, etc.
• Patient education and hands-on assistance

Home Visits by Specialists

• Physicians and nurse practitioners experienced in palliative care
• Coordination with your primary care doctor and specialists

When to Start Palliative Care at Home

How to start palliative care with senocare?

Initial Contact & Assessment

Reach out to Senocare by phone or email (e.g., +91 8800700100 to express your interest in palliative home care.

Their Care Manager will schedule an in-home assessment by a multidisciplinary team—including doctors, nurses, and social workers—to evaluate the patient’s medical, emotional, and spiritual needs .

Personalized Care Plan Development

Based on the assessment, Senocare’s team will propose a tailored care plan. This plan typically includes:

• Symptom management: pain, breathlessness, nausea control
• Nursing care: wound care, injections, vital monitoring
• Physiotherapy, if needed
• Emotional & spiritual support via counselors or chaplains
• Caregiver training and guidance for family members

Implementation at Home

Once the plan is agreed upon:

• Regular nurse and therapist visits are scheduled (daily or weekly depending on need)
• Care Manager oversight ensures coordinated and consistent care
• 24×7 emergency support is available via a helpline
• Necessary medical equipment and supplies (beds, oxygen, wound kits) are arranged

Ongoing Monitoring & Adjustments

The care team regularly:

• Tracks symptom control and adjusts medications
• Offers emotional and spiritual counseling
• Trains caregivers on tasks like medication admin, mobility, hygiene
• Updates the plan as the situation evolves

Other senior care options provided by senocare

Medical & Therapeutic Care

• Periodic health check-ups and vitals monitoring
• Geriatric doctor consultation (tele-consult & home visits)
• Post-operative nursing and wound care at home
• Physiotherapy sessions in your home
• Medicine management and delivery
• Lab tests & sample collection at home Emergency assistance for medical crises
• Rental of medical equipment (e.g., oxygen, beds, diapers)
  Personal Care & Support
• Trained nurses/home attendants to assist with daily living: bathing, feeding, mobility, catheter care, injections, etc.
• 24×7 emergency helpline for immediate support
• Dedicated Care Manager as your day-to-day coordinator and trusted support person
  Emotional, Cognitive & Spiritual Well-Being
• Counseling services for emotional support and geriatric mental health concerns Dementia and Parkinson’s care programs (including cognitive support) Spiritual and social support through companionship, events, and milestone celebrations

Home & Daily Life Assistance

• Companion services to beat loneliness and provide engaging interactions
• Home maintenance and security: deep cleaning, repairs, CCTV installation
• Technology help: app installation, virtual meeting setup, phone/computer tutorials

Case Study

A daughter’s journey with her father’s alzheimer’s

Punita’s personal experience of caring for her father with dementia, she hope to encourage others to openly talk about the challenges and the best ways to handle such health issues. The stigma surrounding these conditions often leads to families feeling unnecessarily embarrassed, hiding, and not seeking help, which is much needed while caring for elders suffering from such health issues. These conditions are not personality or character flaws; they are diseases that affect millions of people worldwide, and they are not something to be ashamed of. “It’s not always easy to walk the talk, but now more than ever, she believe palliative care is the best approach for treating those in terminal conditions. Her first-hand experience has shown that palliative care surpasses other treatment procedures. It prioritizes comfort, dignity, and overall well-being, encompassing physical, emotional, psychological, and spiritual aspects. Palliative care can be provided at any stage of a serious illness, not just end-of-life. It complements and enhances traditional treatments, ensuring that patients receive the best possible care.

“To read more about the amazing journey where Palliative care and Dolls brought Life back into my father’s life, click Here.

References

• What are palliative care and hospice care?
• Goswami, S. (2021, July 21). Home Based Palliative Care. Intech Open eBooks. https://doi.org/10.5772/intechopen.98648I In Text Citation: (Goswami, 2021)
• World Health Organization Programme on Cancer Control: Developing a Global Strategy for Cancer WHO, Geneva (1998)
• Cancer Pain Relief with a Guide to Opioid Availability (2nd edition), WHO, Geneva (1996)

India-Specific Guidelines and Models

• CanSupport’s Home-Based Palliative Care Guidelines: Developed over 25 years of experience, these guidelines provide a comprehensive framework for delivering palliative care at home. They cover aspects such as patient assessment, symptom management, and caregiver support.
• PALCARE’s Clinical Guidelines: The Jimmy S Bilimoria Foundation’s PALCARE developed 39 evidence-based clinical guidelines for home-based palliative care in Mumbai. These guidelines address various aspects of care, including pain management and patient support.

Global Best Practices and Frameworks

• RACGP’s Home-Based Palliative Care Guidelines: The Royal Australian College of General Practitioners outlines key principles for home-based palliative care, emphasizing the importance of compassionate care, advance care planning, and symptom management.
• IntechOpen’s Home Palliative Care Model: This resource discusses the components necessary for effective home-based palliative care, including team composition, infrastructure, and essential medications.

Research and Evidence-Based Studies

• Home-Based Palliative Care: Known Benefits and Future Directions: This study highlights the cost-effectiveness and benefits of home-based palliative care, including symptom alleviation and reduced hospitalizations.
• Twenty Years of Home-Based Palliative Care in Malappuram, Kerala: A descriptive study examining the implementation and outcomes of home-based palliative care in Kerala, showcasing the effectiveness of community-based models.