India's Largest Home Care Provider Prepares for Skyrocketing Need

By K.M. Noordeen, Chair
Alpha Palliative Care, India

Recognizing the skyrocketing need for palliative care in India, Alpha Palliative Care, based in the state of Kerala, is actively preparing to contribute to the massive efforts required.

As a developing country with a large population, India lacks facilities to care for its terminally ill citizens. In the absence of acceptable quality palliative care, people with advanced illnesses like cancer are often forced to stay in hospital intensive care units, despite their illnesses being diagnosed as incurable.

Statistics show a clear need

Alpha Palliative Care, established to provide home care, currently deploys more care teams daily than any other home-based palliative care provider in India. From May 2005, when it opened, until the end of March 2024, 57,692 patients were cared for from its original site and 18 offshoots, called link centers. 

Each link center, organized by Alpha but owned and run by community volunteers with Alpha's support, serves a population of 300,000. 

People with advanced cancer, renal disease, Parkinson's, Alzheimer's, and those permanently bedridden due to accidents or cerebrovascular diseases should be able to enjoy their lives at home while receiving medical care from doctors and nurses specially trained in palliative medicine, an integral branch of modern medicine.

Reach expanded

Alpha's 18 link centres are spread across four districts, and discussions to establish more are ongoing. For now, 46 teams of nurses and doctors provide home care to patients whose doctors have advised them that further treatment is futile. Each team visits 10 to 15 patients every day, six days a week.

Each link center comprises three nurses, two drivers, a cook who also does housekeeping, and one physiotherapist with their assistant. A certified palliative care doctor spends two days a week at the centers and consults with patients by video conferencing on other days.

Hospice added early on

Recognizing the care needs of low-income, frail elders with no caregivers in the home, a relatively rare occurrence in India, Alpha Palliative Care also established a 13-bed hospice in 2006. The hospice offers end-of life-care, palliative physiotherapy, dialysis care, and long-term care. A second hospice with at least 135 beds is expected to open by mid-2025. 

A community-owned model

Alpha Palliative Care is owned and operated by the local communities. There is no cost to patients for the services delivered or medicines provided. Funds are mostly generated by small donations, usually 100 rupees (USD $1.20) per month by way of bank transfer, though some donors give larger amounts. 

While doctors and nurses focus on improving physical issues by carrying out much-needed procedures during home care visits, trained volunteers from the community with similar cultural backgrounds could address the financial, psychosocial and spiritual needs of patients and their families. Alpha Palliative Care has its own training department that offers a six-week Basic Certificate Course in Palliative Care (BCCPM) to doctors, nurses, and physiotherapists.

By establishing palliative care centres in every town and hospices in every district, and by offering the option to remain at home thanks to medical support, the quality of life of thousands of more people yearly could be improved, and their pain and suffering alleviated. 

K.M. Noordeen flanked by ASHA (Accredited Social Health Activists), who receive palliative care awareness training by Alpha Palliative Care. The all-female ASHA is a concept that was developed and has been funded by the government since 2005: there are 1 million ASHA in India (1 for every 1,400 people). ASHA's trained community volunteers can identify people who require palliative care and palliative physiotherapy. Photo provided by Alpha Palliative Care; used with permission.

For more information visit the Alpha Palliative Care website or write to: [email protected]

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