When the curtain of life falls...

SILENCE PERVADES the room. There is hardly any sign of life in the feeble woman on the bed. Science will assert that there is a faint heart beat making sedate attempts to sustain life. Even when the drops of water given well up and meander down the cheeks, she doesn't stir. It is an exertion her frail body can't afford. As her dear ones stand around with troubled minds waiting for the end, a group of youngsters enter the scene...

Well, if you wonder who these people could be and what they could do in a disturbing situation like this, read on... They represent the Chennai-based DEAN Foundation, a voluntary organisation specialising in palliative care - taking care of the terminally ill, to put it jargon-free. This multi-professional team of medical personnel, trained councellors and social workers visits your doorstep and offers palliative care (management of pain, psycho-social help etc.) and bereavement support to the needy.

According to Ms. Deepa Muthaiya, one of its founder trustees, "Palliative care as a specialisation has not caught on in the country as in the West. The DEAN Foundation (acronym for Dignify and Empower the Ailing and the Needy) is a hospice and palliative care centre, launched recently to stress the need for comfortable care to the terminally ill. In essence, palliative care affirms life and regards dying as a normal process, does not intentionally hasten or postpone death, provides relief from pain and other distressing symptoms, integrates social, psychological and spiritual aspects of care, thereby enabling patients to come to terms with their situation, help patients live as actively and creatively as possible and offer a support system to help families cope with the patient's illness and also in bereavement."

Generally patients are referred to the Foundation by the doctors themselves. Routine check-ups, dressing of wounds, medication, councelling sessions etc. are taken care of by the Foundation members at the home itself.

"Our approach is scientific," says Deepa, elaborating the stages a dying person goes through. First it is facing the threat. Anger, anxiety, shock, denial and guilt are some of the common emotions. Next it is the chronic stage in which there is a diminution of intensity of emotions, followed by depression. The last stage is acceptance - the patient is mentally prepared for the end. We assess each stage and offer support accordingly. Even the intensity of pain is graded in a scale of ten before administering medicine. We also have the licence for the possession and dispensation of morphine. Usually, we coordinate with the patient's doctor in assessing the case clinically and deciding the treatment."

So far, the DEAN Foundation (19, Dharmaraja Koil Street, Kilpauk Garden, phone-6454949) has about 70 patients on its rolls, a majority of whom are cancer-afflicted. And as for funds to sustain this free compassionate service, "much depends on donations from individuals and organisations. Sometimes, the family of the deceased help us with medical expenses. Yet it is a virtual struggle," she says.

At present there is a couple of beds in the compact Foundation premises too, for patients wishing to come out of homes for a change. Counselling is also done here. "We want patients to die in dignity...not as neglected individuals with a devastated psyche." And that rightly sums up the Foundation's endeavour.

T. KRITHIKA REDDY

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