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India: Not A Country To Die In

October 10, 2017

Image for representation purposes only.

 

With my father and two dear elderly friends dying in the past month, I'm thinking a lot about end-of-life care. Living in India, this report does nothing to reassure me.

 

In a White Paper done by the Economist Intelligence Unit, 80 countries were ranked on quality and affordability of care available to dying people, skill and number of staff and the quality of hospital and hospice environments. It also considered public awareness about end-of-life issues and options for care.

 

In every ranking, India came close to the bottom. Not only are most hospitals abysmal in quality and affordability; not only are many nurses and doctors callous and lacking in any kind of bedside manner - there is also a reluctance to discuss or even acknowledge death, even when it is staring us in the face. 

 

Open, honest discussions people have with their families and loved ones to share their fears, hopes and wishes for their final days must happen over days, weeks, sometimes longer. They give people a chance to express their love, their regrets, their apologies, their parting words of advice or forgiveness. They seem to be essential for a peaceful, happy death. But they can only happen if we are able to admit that death is inevitable.

 

My father died in America and one of my two friends died in Dubai; both were surrounded by loved ones and both were given good care at the end.

 

Funeral in a church; coffin in aisle, mourners all in black.

 

The third died here in India. She, too, had a peaceful and dignified death, at home, surrounded by her family and attended round-the-clock by people who loved her. But that was solely due to the courage and creativity of her children and their determination to honour her wishes and save her from the clutches of the Indian medical system.

 

Auntie had a stroke at around 10 in the morning. An ambulance was at the house within 15 minutes and we had her in the hospital by a little before 11. In spite of being educated, confident and insistent; in spite of having pull in the hospital and the money to afford whatever was needed, her family simply could not move the system. The ER doctor was a glorified intern, incapable of making any medical decision and afraid, it seemed to contact the attending physician. The neurologist was on rounds. His phone was switched off. No one else was available. Precious hours were lost. When the doctor finally did arrive, he admitted that the window of opportunity had closed. There was nothing they could do but wait and watch.

Image for representation purposes only.

 

The next few days were an ICU-induced nightmare. Auntie was now in a coma. Without asking her children for permission, a feeding tube was put in and a drip set up. The hospital was dirty, yet Gestapo like rules limited their access to their mother to five-minute visits twice a day because of fear of "infection." And while the doctors were candid that her condition was hopeless, they could not officially recommend taking her home.

 

"How will you manage her care?" they pointed out. "You have no medical background."

 

 

Done well, death can be a beautiful and liberating experience, a chance for families to come together and to heal, to share memories and hope, to embrace both the past and the future and to complete the great circle of life. 

 

(Abstracted from Jo's Blog)

Image for representation purposes only.

 

 

 

 

 

 

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