End-of-life care of terminally ill geriatric cancer patients in northern India.

ABSTRACT

BACKGROUND: The geriatric population in India is increasing, and so is the prevalence of cancer. We aimed to study the knowledge, attitude and practices of end-of-life care issues of terminally ill geriatric cancer patients in our region. METHODS: A pilot cross-sectional qualitative study using case studies, focus group discussions on providers and recipients of palliative care, an open-ended, interviewer administered questionnaire on specialist doctors and practitioners (50), geriatric cancer patients (20) and healthy family members of patients (30), was done in Lucknow, the capital of Uttar Pradesh, India. RESULTS: Only 14 physicians (28%) could enumerate more than 3 important technical elements of end-of-life care. Two physicians (4%) utilized palliative care services but none had received training themselves. The explanations and counselling provided by physicians were mostly inadequate, incomplete and did not fully satisfy the patients and their relatives. Of the cancer patients, 19 (95%) desired to use special services but were unaware of such facilities. There was only one charitable organization for needy geriatric cancer patients in Lucknow. No specific health scheme existed in the programme of the Government of Uttar Pradesh. CONCLUSION: The knowledge and practices of physicians and specialists were not up to the expectations and requirements of terminally ill cancer patients. Curriculum-based learning or organized teaching of end-of-life care issues was non-existent. Western countries have well-organized subspecialty facilities for end-of-life needs; such facilities are lacking in India. Capacity building for the care of terminally ill geriatric cancer patients is urgently required in north India.