End of Life Care of Elderly – The neglected counterpart in Indian Context
Abstract
The modern health care strives to promote optimum health and wellbeing with special emphasis to
geriatric population but the end-of-life care for elderly remains obscure with limited research evidence
pertaining to ageing population. The term often revolves around cancer patients in the palliative
dimension. End-of-life care for elderly in the Indian context with its unique social, cultural, economic,
and legal complexities have not been adequately explored. The spiritual socio-cultural, economic, and
care perspectives are important to address when the health care spectrum is becoming more concerned
about the growing population of elderly. An overview of the possible challenges and specific strategies
to deal with this issue can empower nurses and other health care professional to perceive the depth of
situation. How to overcome these challenges and barrier of end-of-life care is that the health care
professionals must prepare the patient and family well in advance by instituting measures like, truthful
communication, financial and legal advice, safeguarding the values and preferences and
acknowledging autonomy in decision making. Death and dying of elderly, conceived in perspectives of
Indian cultures is explained in this review.
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Naik BS, Biradar S. End-of-life care policy: an integrated care plan for the dying. Indian J Crit Care
Med. 2015 Apr 1;19(4):240. doi: 10.4103/0972–5229.154580.
Sharma H, Jagdish V, Anusha P, Bharti S. End-of-life care: Indian perspective. Indian J Psychiatry.
Jan;55(Suppl 2);Suppl 2:S293–8. doi: 10.4103/0019–5545.105554.
Macaden SC, Salins N, Muckaden M, Kulkarni P, Joad A, Nirabhawane V, Simha S. End of life
care policy for the dying: consensus position statement of Indian Association of Palliative Care.
Indian J Palliat Care. 2014 Sep;20(3):171–81. doi: 10.4103/0973–1075.138384.
Jayaram R, Ramakrishnan N. Cost of intensive care in India. Indian J Crit Care Med. 2008
Apr;12(2):55–61. doi: 10.4103/0972–5229.42558.
Angus DC, Barnato AE, Linde-Zwirble WT, Weissfeld LA, Watson RS, Rickert T, Rubenfeld GD,
Robert Wood Johnson Foundation ICU End-Of-Life Peer Group. Use of intensive care at the end of life in the United States: an epidemiologic study. Crit Care Med. 2004;32(3):638–43. doi:
1097/01.ccm.0000114816.62331.08.
Kapadia F, Singh M, Divatia J, Vaidyanathan P, Udwadia FE, Raisinghaney SJ, Limaye HS, Karnad
DR. Limitation and withdrawal of intensive therapy at the end of life: practices in intensive care
units in Mumbai, India. Crit Care Med. 2005;33(6):1272–5. doi:
1097/01.ccm.0000165557.02879.29.
Chaturvedi SK. Spiritual issues at end of life. Indian J Palliat Care. 2007;13(2):48 52. doi:
4103/0973–1075.38899/2/48/38899. [Last cited 2012 Jun 28].
Firth S. End of life: A Hindu view. Lancet. 2005;366(9486):682–6. doi: 10.1016/S0140–
(05)67141–3.
Bauer-Wu S, Barrett R, Yeager K. Spiritual perspectives and practices at the end of life: a review
of the major world religions and application to palliative care. Indian J Palliat Care. 2007;13(2):53.
doi: 10.4103/0973–1075.38900.
Srivastava V. Euthanasia: a regional perspective. Ann Neurosci. 2014 Jul;21(3):81–2. doi:
5214/ans.0972.7531.210302.
Narayanasamy A. Palliative care and spirituality. Indian J Palliat Care. 2007;13(2):32 41. doi:
4103/0973–1075.38897.
Gielen J, Broeckaert B. End of life ethics in a Hindu context: an analysis of the difficulties related
to the determination of the Hindu attitude. Eur J Palliat Care. Admin Tenth Congr EAPC. 2007;153.
Bullock K. The influence of culture on end-of-life decision making. J Soc Work End Life Palliat
Care. 2011 Feb 28;7(1):83–98. doi: 10.1080/15524256.2011.548048.
Firth S. End of life: A Hindu view. Lancet. 2005;366(9486):682–6. doi: 10.1016/S0140–
(05)67141–3.
Bülow HH, Sprung CL, Reinhart K, Prayag S, Du B, Armaganidis A, Abroug F, Levy MM. The
world’s major religions’ points of view on end-of-life decisions in the intensive care unit. Intensive
Care Med. 2008;34(3):423–30. doi: 10.1007/s00134–007–0973–8.
Kamaka ML. Designing a cultural competency curriculum: asking the stakeholders. Hawaii Med J.
Jun;69(6);Suppl 3:31–4.
Tjernberg J, Bökberg C. Older persons’ thoughts about death and dying and their experiences of
care in end-of-life: a qualitative study. BMC Nurs. 2020 Dec;19(1):123. doi: 10.1186/s12912–020–
-x.
Sprung CL, Woodcock T, Sjokvist P, Ricou B, Bulow HH, Lippert A, Maia P, Cohen S, Baras M,
Hovilehto S, Ledoux D, Phelan D, Wennberg E, Schobersberger W. Reasons, considerations,
difficulties and documentation of end-of-life decisions in European intensive care units: the Ethicus
Study. Intensive Care Med. 2008;34(2):271–7. doi: 10.1007/s00134–007–0927–1.
Mani RK, Amin P, Chawla R, Divatia JV, Kapadia F, Khilnani P, et al. ISCCM position statement:
limiting life-prolonging interventions and providing palliative care towards the end of life in Indian
intensive care units. Indian J Crit Care Med. 2005;9:96–107.
Mani RK. End of life care in India. Intensive Care Med. 2006;32(7):1066–8. doi: 10.1007/s00134–
–0185–7.
Barnett VT, Aurora VK. Physician beliefs and practices regarding end-of-life care in India. Indian
J Crit Care Med. 2008;12(3):109–15. doi: 10.4103/0972–5229.43679.
Economist Intelligence Unit, Commissioned by LIEN Foundation. The quality of death: ranking
end-of-life care across the world.
Curtis JR, Vincent JL. Ethics and end-of-life care for adults in the intensive care unit. Lancet. 2010
Oct 16;376(9749):1347–53. doi: 10.1016/S0140–6736(10)60143–2.
Sharma H, Jagdish V, Anusha P, Bharti S. End-of-life care: Indian perspective. Indian J Psychiatry.
Jan;55(Suppl 2);Suppl 2:S293–8. doi: 10.4103/0019–5545.105554.
Mani RK, Amin P, Chawla R, Divatia JV, Kapadia F, Khilnani P, Myatra SN, Prayag S,
Rajagopalan R, Todi SK, Uttam R. Guidelines for end-of-life and palliative care in Indian intensive
care units: ISCCM consensus Ethical Position Statement. Indian J Crit Care Med. 2012
Jul;16(3):166–81. doi: 10.4103/0972–5229.102112.
Novak B, Kolcaba K, Steiner R, Dowd T. Measuring comfort in caregivers and patients during late
end-of-life care. Am J Hosp Palliat Care. 2001 May;18(3):170–80. doi:
1177/104990910101800308.
DOI: https://doi.org/10.37628/ijgn.v4i2.1998
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