least amount of pain, and an atmosphere based on communication and free of falsity (Yamazaki 1990). Research shows that being a long- term inhabitant, particularly in an oncological ward or wing, is evidently and even observationally a very isolated and morose experience with inadequate social contact or personal interaction or rejuvenating activity. Hospice patients, in contrast, were significantly less lonely, spending considerable amount of their time either engaged in some activity or with their relatives or nurses. Although almost none of the patients spend the majority part of their day or night with nurses, patients and nurses within the hospice setup spend significantly more time together, and these meetings or interactions more frequently last longer. Nursing care, however, is mostly oriented at `doing' a particular task for the patient that they are required to rather than `being' as a companion, jester or listener, i.e. when attending to the patients, nurses have a particular task to accomplish within stipulated time and are also burdened with the responsibility of multiple patients. (Ramussen and Sandman, 1997) For now, it is difficult to determine as to how much patients preferably and in actuality spend their waking time or limited good days in different surroundings. It is so because the only available data is from observational studies at similar functioning institutions for the elderly (Nolan, 1995), and of terminally ill patients in medical wards (Mills, 1994). Neither paints a joyful picture of a setting. Images people assume are patients reading as is revealed usually happens. Patients spend most of their time unaware, uninvolved, amongst themselves and isolated. This can have a negative impact even on the mental health, affecting other physiological symptoms. Information about hospice practice and its evolution can be gained by examining patient activities at a hospice.
Figure 2-1 Components of Palliative Care
2.2.2
The Need for Palliative Care in India Of the 2.1 billion people living in India, less than 1 percent have access to palliative
care. However, massive progress can be seen in the last 50 years. (Rajagopal, 2015). Initially pioneered by non-government organization, the issue and need has now been recognized by Sparsh Hospice, Hyderabad
7
