Palliative care should be multidisciplinary. It has no restriction regarding approaches and specialties and should be given in a completely customized way to the patient. Further than pain relief administration; physiotherapy, occupational therapy, vocational therapy and clinical psychology are usually at the core of palliative care. The objective for Palliative Care should be simple: Understand what the patient wants and avoid unrequired admissions in ICU if the patient prefers being at home.
There are many most recent developments, medicines and alternative medicines pertaining Palliative care. Most of them are Ayurvedic and spiritual in nature. Allopathy has a small presence. Some Palliative Care methods include Aromatherapy, Acupressure, CAM (Complementary and Alternative Medicine), Meditation and Relaxation and Cognitive Behavioral Therapy. Others include Yoga, Reiki, Reflexology and Alternative Pain Treatments.
The perception of the cost of palliative care is still an issue. A large number of patients and their families are ready to pay for interventions, even if the condition of the patient does not justify it, but do not understand the value of palliative versus curative approaches.
The other challenge is that the palliative market is mostly informal, led by Ayurveda and other alternative therapies. Allopathic doctors are not encouraging the usage of such treatments as no one knows the effect of alternative therapy in conjunction with allopathy. But the number of Ayurvedic doctors addressing palliative care has skyrocketed in the last few years, and there are more than 500 of them across Mumbai.
The size of the formal allopathic palliative care is minuscule, and the bulk of it is directly coming from the palliative pharma market. As a matter of fact, palliative care is still mostly considered as an ancillary specialty to anesthesiology. In other countries, palliative physicians are delivering the palliative care, training and accompanying the informal caregivers to handle stressful situations in the best way.
In India, only a handful of such professionals exist. The size of palliative services market is therefore incredibly tiny while there is an incredible latent demand. It is primarily driven by hospices. Shanti Avedna Sadan in Bandra, Mumbai, was one of the first institutions to be dedicated to palliative care but is also strictly restricted to the end of life patients, and their work is mostly focused on environmental therapy. However, the first formal training programs in Palliative Care have been launched, including by Tata Memorial Hospital, and full batches with an MD in Palliative Therapy are going to graduate shortly, which make us predict a boom in the practice.