What is Palliative Care?
Palliative care is care that provides relief from symptoms resulting from disease or injury.
In comparison to curative care, which is undertaken with the goal of curing disease, palliative care is meant to make the patient more comfortable. The definition of palliative care is "to make a disease or its symptoms less severe or unpleasant without removing the cause." Palliative care will lessen or "palliate" the symptoms and improve the patient’s quality of life.
Most people have experienced palliative medicine, which focuses on comfort care, symptom management, and pain relief.
If you break a bone, the doctor treats it by immobilizing it with a cast and prescribing medications for pain management to make you comfortable. The cast is curative, while the medications are palliative: they improve the quality of your life while you and your physician address the broken bone.
Another example: An oncologist who prescribes anti-tumor treatments for cancer will also address nausea, depression, and anxiety by prescribing an anti-anxiety drug, recommending a therapist, or arranging for pet visits. A social worker or chaplain will provide family support. All of these coping mechanisms are considered palliative: they improve the quality of a patient's life while the patient and physician address the cancer.
On This Page:
- What is the history of palliative care?
- What services does palliative care provide?
- What are the benefits of palliative care?
- Who needs palliative care?
- How long can you be in palliative care?
- Where can you receive palliative care?
- How do you pay for palliative care?
- When is the right time for palliative care?
What Is the History of Palliative Care?
Palliative care, a board-certified medical specialty since 2006 in the US, has been around for centuries. Today, 1,700 hospitals with 50 or more beds offer a palliative specialist or team. They work with a patient’s healthcare team and specialists to address the physical, psychological, social, or spiritual distress of serious illness and its treatment.
What Services Does Palliative Care Provide?
The specifics of palliative care vary from case to case, as treatments are intended to address a patient’s unique needs and tolerance for discomfort.
Palliative care begins with a conversation to determine the patient’s symptoms, needs, and any medications that may provide relief. For some patients, this includes ending medications that cause uncomfortable side effects.
Palliative care providers may also use approaches that don’t rely on medication, such as specialized nutrition or breathing exercises. For additional relief, the palliative care team can introduce complementary therapies to address specific symptoms.
The palliative care team routinely communicates with the patient to determine the intensity of their pain and other symptoms. Based on that information, they assess appropriate treatment options together.
When a patient is unable to communicate or otherwise unable to describe their own experience, the care team relies on pain assessment tools and clinical judgment to facilitate symptom relief.
Services and therapies that may be included in palliative care include:
- Nutritional guidance
- Comfort-focused techniques for breathing, meditation, or listening to music
- Massage therapy
- Caregiver support
- Care coordination
- Community resources and support group referrals
- Financial counseling
- Advance care planning
- Grief and spiritual support
What Are the Benefits of Palliative Care?
Palliative care provides relief in a variety of ways. Physical symptoms such as pain, fatigue, loss of appetite, nausea/vomiting, and sleep loss can all be mitigated with palliative approaches, whether through medications, nutrition, deep breathing, or acupuncture.
For patients and families struggling to cope with a serious diagnosis, palliative care can address depression, anxiety, and fear by employing counseling, support groups, and family meetings.
According to a 2023 study by NORC at the University of Chicago, long-term benefits of end-of-life palliative care include:1
- Better outcomes, including longer life expectancy for the patient
- A higher quality of life, with patients and caregivers expressing greater satisfaction
- Reduced mental and physical distress
- Preparation for end-of-life preferences
Who Needs Palliative Care?
Generally, palliative care is provided within the context of serious illness: chronic, progressive pulmonary disorders; renal disease; chronic heart failure; HIV/AIDS; progressive neurological conditions; cancer, etc. It supports a patient’s physical, emotional, and psychosocial needs, providing comfort and improving quality of life.
Palliative care provides relief for symptoms for diseases such as:
- Alzheimer’s/other dementias
- Cancer
- COPD/lung diseases
- Heart disease/heart failure
- HIV/AIDS
- End-stage liver disease
- Kidney disease
- Multiple sclerosis
- Parkinson's disease
- Stroke/neurological conditions
What Is the Difference Between Palliative Care and Hospice?
Although palliative and hospice care both address symptoms, hospice is appropriate only when the patient has a life expectancy of fewer than six months 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, starting from the point of diagnosis and continuing throughout curative treatments.
How Long Can You Be in Palliative Care?
Palliative care can occur at any point in life, for any duration, and it can occur in conjunction with curative care. Hospice care, which includes palliative care, is designed to provide comfort and dignity in the last six months of a patient’s life.
Research suggests that earlier implementation of palliative care positively impacts patient and family satisfaction with the care they receive, patient perceptions of pain, and even patient survival rates. A hospice patient who chooses to discontinue hospice services can continue to receive palliative care.
Where Can You Receive Palliative Care?
Palliative care, like hospice care, does not necessarily take place in a fixed location. Patients can receive palliative care:
- In their home
- In a senior living community/assisted living facility
- In a nursing home
- In a hospital
- In an outpatient unit
How Do You Pay for Palliative Care?
Palliative care visits may include a copay but are typically covered by Medicare and Medicaid. Other insurance plans may vary. Some healthcare plans and Medicare Advantage plans may offer coverage for palliative care services and visits.
When Is the Right Time for Palliative Care?
Palliative care is appropriate at any state of disease, and palliative services may take place at the same time as curative treatment. However, the discussion of palliative medicine typically happens in the event of a serious illness to offer complex symptom relief. Like hospice, palliative care provides comfort care and a higher quality of life during the disease trajectory.
1 NORC at the University of Chicago (2023). Value of Hospice in Medicare. Available at: https://www.nhpco.org/wp-content/uploads/Value_Hospice_in_Medicare.pdf