What Is Palliative Care?
Palliative care has been a board-certified medical specialty since 2006 in the US, but the practice of comfort-focused care has been around for centuries. Palliative care treatment grew out of the hospice movement.
Today, 80 percent of hospitals with 300 or more beds offer a palliative specialist or palliative team that works with the patient’s other physicians to address the physical, social and spiritual distress of serious illness and its treatment and care choices.
As opposed to curative care, palliative care provides relief from symptoms resulting from disease or injury. For instance, if you break a bone, you seek a cure: the doctor sets it and keeps it immobile to help it heal. But they also prescribe medications to treat your pain and to make you comfortable. The pain medications lessen or “palliate” the symptoms and improve your quality of life.
But if palliative care is different from curative care, it is also different from hospice care. Hospice care addresses symptoms, just as palliative care does, but is appropriate only in the last six months of life, as estimated by the patient’s physician. Hospice is offered in place of curative treatment, whereas the comfort of palliative care is available at any time in a patient’s disease, from diagnosis and throughout curative treatments.
Generally, palliative care is discussed in the context of serious illness: chronic, progressive pulmonary disorders; renal disease; chronic heart failure; HIV/AIDS; progressive neurological conditioners; cancer; etc. It focuses upon the nature of treatment and the possible and not possible outcomes of therapy options.
The intention of palliative care is to provide information to the patient and family so they can determine their goals and desired outcomes. Thus the term “Goals of Care Discussion.”
What Are the Benefits of Palliative Care?
Palliative care is most often provided by a team of professionals very similar to an interdisciplinary hospice team. Clinical evaluation and care discussions are usually provided by physicians, nurse practitioners and RNs. At times, social workers and chaplains are also involved.
Palliative care provides relief in a variety of ways. For patients and families struggling to cope with a serious diagnosis, palliative care can address depression, anxiety and fear by employing counseling, support groups, family meetings and the like. Physical symptoms such as pain, fatigue, loss of appetite, nausea/vomiting and sleep loss can all be mitigated with palliative approaches, whether through drugs, nutrition, deep breathing or acupuncture.
The Palliative Consult
For patients and families facing worries beyond the illness itself, a member of the VITAS palliative care team can assist with questions and help find resources to address financial, legal, employment, transportation and housing issues. And whether your faith is your anchor, or it feels like it has abandoned you—or even if you have no religious background at all—palliative care can address any spiritual questions in light of your culture and traditions.
Palliative care has been proven effective in improving quality of life. When your symptoms are controlled, and you feel like someone is there to listen, you feel better and live better. Palliative consults result in lower healthcare costs, because they may make you feel well enough to choose to stay out of the hospital and say no to unnecessary tests and treatment; at some point, more treatment does not equal better care.
How Does VITAS Approach Palliative Care?
At VITAS, palliative care begins with a plan uniquely tailored by an interdisciplinary team to meet the needs of the patient. The team can work with newly diagnosed patients and those struggling with the after-effects of curative therapies. Some members of the palliative team may be board certified in hospice and palliative medicine; others range from chaplains to acupuncturists.
A palliative consult with the patient provides timely and specific information that helps the patient and family understand what palliative medicine brings to the table, and helps physicians and the rest of the interdisciplinary team provide the most appropriate care.