I appreciate how your post addresses the all-important issue of getting care at home, Ilija (and Aaron Wong , I appreciate your connection-making!). To some degree, your wonderful idea for a mobile team is up and running in Kerala, India through an amazing organization called Pallium India (http://opinionator.blogs.nytimes.com/2016/01/12/in-india-travelling-dispensers-of-balm-at-deaths-door/?_r=0). Healthcare teams of doctors, nurses and social workers go out together in vans to visit homebound patients. Their work is supported by a robust network of neighborhood volunteers, who check in on the patients in between these clinical visits. This support is crucial, I believe, as most individuals who are dying (or who are very medically fragile and could cross the terminally-ill line at any second) need care (monitoring for comfort, giving as-needed medications, providing incontinence care, preventing falls, for examples) throughout the day and sometimes night. For this kind of community-based caregiving, I wonder if we could look to the Village movement (http://tedxboston.org/speaker/willett) or Frantisek Rokusek 's idea for FLAT&CARE [Share a flat, Share the care] : reduce costs by Accommodation Sharing .
Yes, Aaron! I really enjoyed Garrett Eng 's contribution. I love intergenerational, win-win arrangements. Another one is the move to have nursery schools within nursing homes: http://www.theatlantic.com/education/archive/2016/01/the-preschool-inside-a-nursing-home/424827/ In one such nursing home, the staff receive a 20% discount on enrollment in the nursery school for their children--which I imagine would be quite an incentive for those making nursing assistant wages. Both college-aged youth and young children would do much, I have to believe, in bringing the "vibrancy and life" James Takayesu mentions in his comment. I wonder how/if individuals could benefit from such arrangements closer to the end of their lives, when more hands-on care is needed and there is often a shift to a more internal orientation.
Thank you for posting this video, Nikhil. Dr. Palat mentions working with Human Rights Watch, which puts out many publications on the state of palliative care around the world. In one of these publications, it is reported that "...in 35 of 192 countries reviewed, fewer than 1 percent of patients with moderate to severe pain from terminal cancer or HIV could get the strong pain medications they needed. These countries are concentrated in Sub-Saharan Africa, but some are in Asia, the Middle East, North Africa, and Central America." (https://www.hrw.org/news/2011/06/02/global-tens-millions-face-death-agonyhttps://www.hrw.org/news/2011/06/02/global-tens-millions-face-death-agony) The argument could be made that end-of-life care must start with adequate symptom management.