The Word Palliative

The word ‘palliative’ comes from the Latin word palliare, which means to cloak or cover. In the medical context, palliate care implies a caregiving approach towards individuals suffering from major illnesses and their families. According to the World Health Organization (W.H.O), “Palliative care is an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness. It prevents and relieves suffering through the early identification, correct assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual.” While palliative care began with taking care of cancer patients, today palliative care is given to those suffering from diabetes (4.6%), AIDS (5.7%), cardiovascular diseases (38.5%) as well as Parkinson’s disease, rheumatoid arthritis, kidney failure, dementia, drug resistant TB, and neurological diseases among others.

Palliative care includes a range of activities including nursing, paramedical assistance, physiotherapy, and counselling among others. 40 million people around the world requirement palliative care every year, with 78% of them living in middle or low-income countries. Early access to palliative care can reduce the burden on hospitals as well as help patients and their families to deal better with the illness. It can be seen as complementing and enhancing the curative treatment for patients.

Palliative care has its history in the hospice movement pioneered by Dame Cicely Saunders, an English nurse and social worker, who founded St Christopher's Hospice in 1967 as well as the work of Elisabeth Kubler-Ross, a Swiss psychologist, who wrote about near-death experiences in her book ‘On Death and Dying’ in 1969. Inspired by Saunders and Kulber-Ross, the first palliative care ward was founded by Balfour Mount, a urologist, at the Royal Victoria Hospital in Montreal, Canada.

The Evolving Model

Over the years, palliative care has evolved to be a part of the active treatment versus coming in after active treatment is over and the disease is considered incurable. Indeed, medical science has realized the importance of early intervention palliative care to improve the day-to-day experience for the patient, thereby increasing the chances of cure. Palliative care now also involves taking care of the family in the event of the patient’s death by offering psychological, spiritual and social support during the bereavement process. Palliative care therefore covers the entire timeline for a patient from the time of diagnosis of an advanced life-threatening disease till after the death of the patient in certain cases.



Nursing homes or hospices are usually for those individuals who are near the end of their lives. Typically, a nursing home will work towards making the individual comfortable during their last days, however, the approach is not towards being curative. While hospices also emphasize on comfort and reducing pain, they do not offer psychological, spiritual or social support.

Palliative care

Palliative care on the other hand, can take place at any time during a serious illness. Palliative care works hand in hand with your medical treatment. It is a field of medicine which focuses on the psychological and spiritual aspects of an illness as well. Palliative care involves making the day-to-day better for the patient by treating pain, insomnia, nausea, etc. and by addressing the psychological and spiritual aspects. Palliative doctors and nurses are specially trained. Patients and their families can also benefit from counsellors, nutritionists and therapists, as part of palliative care. 

The India Statistics

Palliative care in India is a new phenomenon, being introduced only in the mid-1980s. Some of the first palliative care institutions opened in places like Mumbai, Bengaluru, Trivandrum, Delhi and Ahmedabad. It has since increased its presence throughout the country. 

  • Palliative care service under department of Anesthesiology at Gujarat Cancer Research Institute and the formation of the Indian Association of Palliative Care (1980s)
  • Shanti Avedna Ashram, Mumbai, by Professor D’Souza in 1986
  • Pain clinics at the Regional Cancer Centre, Trivandrum, Kerala, and at Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, with assistance from WHO (1990s)
  • First free palliative care home in north India, CanSupport, founded in Delhi, 1997
  • Cipla Cancer Palliative Care Centre, Pune, Maharshtra, 1997
  • IAPC registered Public Trust and Society in March 1994 
  • Palliative Care Drugs Committee and Educational Task Force, established by IAPC in 1995
  • Kerala became the first state to announce palliative care policy in 2008

Every year, about 1 million Indians are diagnosed with cancer with over 80% presenting at stage III and IV. These individuals are in need of palliative care. Apart from those who are diagnosed each year, another million suffer from cancer pain and are in need of palliative care. Less than a quarter of these patients have access to palliative care in India. 

It is estimated that less than 3% of India's cancer patients have access to adequate pain relief.


Residents may get addicted to pain relief drugs

Patients are given pain relief medication under controlled conditions and supervision. This is to keep them comfortable during their illness. If the tolerance to the pain medication increases, only then is the dosage increased. This is adjustment, not addiction.

Palliative care hastens death

Palliative care does not hasten death. In fact, it makes the patient comfortable throughout their illness and may even prolong the life of person with advance illness.


Palliative care is not an end-of-life treatment. It is a an extra layer of treatment on top of the curative treatment to help the patient have good quality of life while they are going through an illness

Palliative care is only provided in hospitals

Depending on the individual case, palliative care can also be given at home, at a nursing home or hospice or sometimes in hospitals. Patients may be moved to hospitals in case their requirements are more than can be taken care of at home.

You need to be a nurse in order to give palliative care

Palliative care is given by a variety of professionals including counsellors, recreation specialists, paramedics, and nurses depending on the requirement of the patient and their family.

Palliative care is only for cancer patients

Palliative care is for an patient suffering from life-threatening or chronic diseases and at any stage of the illness.

Palliative care costs more

Palliative care costs are similar to those of a hospice or nursing home. Many insurance companies in India today cover palliative care as part of their policies.