OP for patients with serious illness or complex medical problems
The Outpatients Clinic (OP) is for the patients diagnosed with a serious illness or with complex medical problems which includes cancer, cardiac diseases such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), kidney failure, Alzheimer's, Parkinson's, Amyotrophic Lateral Sclerosis (ALS) and many more. Palliative care focuses on the symptoms and stress of the disease and the treatment. It treats a wide range of issues that can include pain, depression, anxiety, fatigue, shortness of breath, constipation, nausea, loss of appetite and difficulty sleeping. These serious illnesses often lead to physical, emotional, spiritual, and social problems that go beyond what the medical team can provide..
In our OP, the patients are received by trained volunteers. They give the patients and relatives an opportunity to ventilate their emotional problems and to explore their social issues. There are nearly 60 volunteers and there will be around 6 to 8 volunteers in the OP at a given time caring for the patients. After registering the patient, the volunteer in charge of the patient takes him/her to the doctor. The doctor goes through the documentation made by the volunteer, listen to the patient, examine, discuss with patient and relatives and arrive at a plan of care. The procedure includes
- Diagnosis, prognosis, end of life or not
- Patient's goals of care
- Comorbidities and other symptoms aside from pain
- An extensive list of current medications for pain as well as comorbid conditions
- The medications or interventions are available at your facility
- Present/past adherence to treatments
- Previous experiences with pain medications, beliefs, cultural, spiritual dimensions
- Patient and family expectations regarding pain management
- The education level of the patient and family
- Evaluation of drug misuse in past or associated risk factors
- Insurance status, socio-economical context, ability to obtain medications or treatment
- Contacts or support persons /transportation ability
- Cognitive function
Infrastructure
There is only one paid doctor but there are about 16 doctors who offer their voluntary service on a regular basis. On an average 40-50 patients visit the OP daily for treatment. The infrastructural work for setting up the Outpatient Clinic has carried out with the financial support to the tune of Rs: 3.50 lakhs from the Local Area Development fund of Thrissur MLA Shri. Therambil Ramakrishnan.