What is Palliative Care?
Palliative care aims to enhance the quality of life of patients and their families who are faced with a life-threatening illness. It focuses on increasing comfort through prevention and treatment of suffering.
Palliative care encompasses the whole self, caring for the physical, emotional, and spiritual needs of patients and their families. Palliative care provides relief from pain and other symptoms of illness such as fatigue, nausea, shortness of breath, and loss of apptetite. It is designed to prevent and relieve these symptoms so you can get on with daily life.
Palliative Care vs Hospice Care
Palliative care can be offered as an early intervention in the course of an illness along with curative therapies meant to prolong life, as opposed to hospice care which focuses primarily on comfort and is intended to cease all curative treatments. Hospice care is appropriate for patients with a terminal illness and/or a life expectancy of six months or less. Hospice care is covered more in depth here.
The Palliative Care Team
It is common practice in the treatment of illnesses to have several different doctors treating separate conditions. For example, someone with diabetes may see an endocrinologist to manage blood sugars, a cardiologist to manage ischemic heart disease, and a nephrologist to manage ischemic kidney disease. A palliative care doctor often acts as the conductor, orchestrating the care between several specialists to produce care that is in perfect harmony.
Palliative care is carried out by a team of professionals who are committed to working together to provide the patient and their family comprehensive care. This team may include:
- Palliative care physicians
- Specialists or general practicioners
- Nurses
- Nursing assistants or home health aides
- Social workers
- Chaplains
- Physical, occupational, and speech therapists
The team can offer support to patients and their loved ones, help them navigate through the healthcare process, and assist in making healthcare choices that are right for them.
Settings of Care
Palliative care can be given in a hospital setting, often times in conjunction with other therapies and treatments such as chemotherapy or radiation. It can also be delivered at a patient’s place of residence such as the patients own home, the home of a family member, an assisted care living facility (ACLF), or a long term care facility (convalescent or nursing home). The goals of care are the same regardless of where a patient receives it. Your doctor, case manager (in the hospital), or social worker can direct you in finding palliative care and we discuss the process more in depth here.
Examples
Because so many people can benefit from palliative care, we will illustrate a few typical scenerios:
A man in his late 50's is diagnosed with late stage prostate cancer. He is hospitalized while undergoing intensive chemotherapy. His prognosis is poor but he is determined to fight. He is having a lot of pain, nausea, and vomiting. His doctor orders palliative care to provide him with expert treatment of his symptoms while working to prolong his life. He continues with his chemotherapy which is shrinking his prostate tumor and providing relief. He is also getting expert pain control and no longer suffers from nausea and vomiting.
An elderly woman with end stage emphysema (or COPD) is having increased shortness of breath and can't walk from her bedroom to the bathroom with stopping for a rest. She is on every medication possible to treat the disease and they are no longer providing her with the relief they once did. Her husband hates to see her like this. She gets very anxious and panicky when she is short of breath and he doesn't know what to do. Her doctor recommends hospice care. Hospice now comes to her home several times a week to help with her care and offer support to her husband. She is on medication to help her anxiety and her sensation of shortness of breath.
A premature infant born at 27 weeks gestation is hooked up to every machine imaginable to keep him alive. He has one set back after another and shows no improvement. His parent's can't bear to see him suffer any longer. They ask their doctor about stopping life support and he refers them to palliative care. The infant is given medications to make him comfortable and pain free. The parent's hold their baby while a chaplain offers prayer. Their child dies peacefully and they are offered the support of bereavement groups and counseling.
All three of these patients benefited from palliative care though their needs and their care were very different.
http://www.who.int/cancer/palliative/definition/en/print.html
