What is palliative care?

We’ve heard the phrase “It takes a village” that’s usually offered when one is talking of raising a child or creating a community, but it can also apply to the medical arena when someone receives the diagnosis of a challenging illness or disease.

Palliative care is a rapidly growing specialty within the field of medicine designed for individuals with serious illnesses. Its primary focus is to offer the patient relief from stress and symptoms associated with the illness while also improving the quality of life for the patient.

This type of care is provided by a trained team of doctors, nurses and other specialists who work together in collaboration with the patient’s other doctors to provide an extra layer of support. Palliative care is appropriate for people of any age and at any stage of illness and can be given simultaneously with curative treatment.

The word palliate is defined as “that which makes (a disease or its symptoms) less severe or unpleasant without removing the cause.” To palliate, therefore, means to alleviate, ease, relieve, diminish or decrease. As a medical specialty, palliative care focuses on the patient’s comfort, care and planning when he is facing serious illness. Patients in these situations may require assistance with pain relief or other challenging physical symptoms. Designed as a helpful approach not only for the patient but also for the family as a whole, palliative care helps everyone involved to emotionally adjust to the illness while at the same time exploring goals of care or planning for the future.

Unlike hospice, which is generally considered to be for terminal patients or those within six months of death, palliative care has no time restrictions. It can be offered to patients at any time and at any stage of an illness, whether terminal or non-terminal. Certainly both palliative care and hospice care provide comfort, but the former can begin at the time of diagnosis and be concurrent with treatment, whereas the latter begins after the treatment for the disease has been terminated and evidence suggests the patient will not survive the illness.

Palliative care can be initiated at any stage–at time of diagnosis, throughout treatment, during follow-up and at end-of-life. This type of care may be offered to people struggling with illnesses such as cancer, heart disease, lung diseases, kidney failure, dementia, HIV/AIDS and ALS. It is given in addition to the care, treatments and recommendations one receives from his or her doctor.

The foundation of the palliative care philosophy is that care is provided and services are coordinated through the efforts of an interdisciplinary team, which can include a team of doctors, nurses, social workers, psychologists, registered dietitians, massage therapists and chaplains. Palliative care may be offered through hospitals, home care agencies, cancer centers or other long-term care facilities. Mutual collaboration and communication are expected among patients, families, palliative and non-palliative health care providers. Of course, a focus on the patient’s peace and dignity is expected to be upheld throughout the term of care.

Among the typical services provided in the care spectrum include assistance with managing physical symptoms, including pain, sleep disturbances, shortness of breath, loss of appetite, nausea or fatigue; and help with managing depression, anxiety or grief. Palliative care offers treatments that include support groups, counseling and family meetings. Counseling is also provided with respect to recovery prospects or decisions that must be made should end-of-life care and related measures be required.

Palliative care offers many proven benefits, including better symptom control, less emotional hardship on both patients and families, and improved care planning.According to information from Baylor Regional Medical Center, “In a study at one of the nation’s top hospitals, palliative care consultation started when the patient was diagnosed with cancer that had spread to other parts of the body not only helped improve symptoms, but significantly increased survival.”

“I believe palliative care is a must in today’s health care environment. Whether a patient is terminal or not, care during long-term illness that is supportive while not always curative is essential to the patient and family. Palliative care involves the whole family and all aspects of care, not just physical. My husband recently died in hospice care. The staff turned a painful time into almost a religious experience. Having seen palliative care from both sides, I am grateful it is an option,” noted Susie, an RN in the Midwest.

If you are interested in palliative care for yourself or a loved one, inquire of your doctor and let her know of your concerns and what issues are most important to you. A physician must order the comprehensive palliative care consultation.
Palliative care is typically covered by health insurance, including Medicare or Medicaid. Check with your provider first and if you do not have health insurance, you can speak with a social worker or the hospital’s financial counselor for more options. HLM

Sources: getpalliativecare.org, caregiverslibrary.org, baylorhealth.org and nlm.nih.gov.