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April 21, 2015

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Home » District » Minhang

Healthcare swan song ensures death with dignity

Staff at palliative care wards in community health centers in Minhang are demonstrating that love, patience and understanding can be strong potions when dealing with the terminally ill. Their work is also changing public attitudes about caring for the dying.

Since the ward at the Xinzhuang Community Health Service Center opened almost three years ago, 192 patients have died in tranquil care there.

The work can be heartbreaking.

Therapist Wu Yuhua said a patient, surnamed Li, who is suffering from intestinal cancer, had to be bundled up in thick winter clothing even during the unseasonal heat wave earlier this month in Shanghai.

Li, 55, has trouble lying down, staying warm and getting comfortable.

“He is usually optimistic,” Wu said. “But the pain in his body sometimes overwhelms his spirit and causes mood swings.”

Wu’s prescription: small talk to distract Li from his distress. She sits with him just chatting about little things. She takes his hand. He calms down and almost smiles.

Service expansion

Palliative care centers have been set up throughout Minhang since the first centers opened in the Xinzhuang and Jiangchuan areas in 2012. As of the end of last year, the district had 102 beds for palliative care, and 168 doctors and nurses working in the field.

“We assess patients before accepting them into the ward,” said Tian Lei, director of the ward. “We assess organ functions, biochemical indexes, self-care abilities and consciousness. Patients with lower scores are more likely to be admitted.”

Medications aside, doctors and therapists try all sorts of therapies to relieve both physical and mental pain. They use music and herbal remedies sometimes to soothe anxiety and relieve depression.

“We give patients music therapy once a day for at least half an hour,” said Tian. “It helps to stabilize blood pressure and heartbeat, and also can ease physical discomfort to some extent.”

Patients’ wishes stand prominent, even if that means bending hospital rules sometimes.

The ward once had a 23-year-old patient with advanced stomach cancer who wanted a console and TV.

The staff allowed the family to bring the amenities.

“The fear of death and anxiety among their loved ones causes much of the ‘pain’ patients have,” said Tian. “So, every day, we spend time going around the wards to give them comfort. We closely monitor their mental status.”

In the Jiangchuan Community Health Service Center, a 79-year-old surnamed Lu has been visiting his dying wife every day for three months.

When she first went to the palliative care ward, doctors gave her only a few days to live. Lu credits her extended life to the excellent care on the ward.

“I always just thought of palliative care as nothing more than death’s door,” he said. “But now I realize there is a lot more to it all. I really have come to appreciate the whole concept.”

Lu said doctors and nurses on the ward are very caring and have made his wife feel relaxed and comfortable.

“I feel better when I see her in a better state,” he said. “Knowing that she can complete her life calmly, I don’t have anything to regret.”

Yu Xiaoqing, director of ward in Jiangchuan, said when the ward first opened, there were always vacancies. Now there is sometimes a waiting list for beds.

“I think this shows a change in public attitude about palliative care,” she said. “People are more open-minded now and willing to accept multiple modes of medical care.”

Spirit spreading

That spirit is certainly spreading.

Students at Shanghai Jiao Tong University has started a program whereby student volunteers go to the wards every Saturday to visit patients who don’t have families nearby.

They read books or newspapers to them, talk to them or just listen to their life stories. It’s a way of easing loneliness.

“Compared with other doctors who may save lives on a daily basis,” said Yu, “our work may not seem so heroic. But showing respect for life is also important to patients.”

Yu said the number of wards may have to be increased in the future to meet demand. In Jiangchuan alone, she noted, there are around 3,000 people suffering from cancer, some of them at advanced stages. But the community currently has only 10 beds, three doctors and five nurses.

“Of course, increasing the number of beds is a matter for authorities,” she said. “What we in the ward have to focus on is improving the quality of service, easing the pain of the patients and helping families cope with sadness and fear.”




 

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