Navigating the complexities of home-based palliative care: Lessons from a case of advanced cancer

Home-based palliative care offers a compassionate way to support terminally ill patients in familiar settings, but its implementation in resource-limited environments is challenging. We share our experience with a 35-year-old man with advanced squamous cell carcinoma of the tongue, previously treated with radiotherapy and brachytherapy, who presented with metastatic pleural effusion and severe respiratory distress. Despite comprehensive symptom management in the palliative care ward-including opioid titration, nerve blocks, and psychological support-his wife faced substantial barriers to providing home care. Financial hardship, lack of family support, and living on a third floor hindered timely crisis management. Although we trained the caregiver, resource limitations led to complications like empyema and sepsis, necessitating readmission. The patient passed away after 5 weeks. This case emphasizes the need for systemic investment in caregiver training, community support, and healthcare infrastructure to address the multifaceted challenges of home-based palliative care in resource-constrained settings.