Examples and Types of Palliative Care
Palliative care focuses on easing stress, providing comfort and addressing complex symptoms—whatever the diagnosis—at any age or any stage of a serious or life-threatening illness.
Here are examples and types of palliative care:
- For an elderly woman whose moderate-stage Alzheimer’s symptoms include agitation and psychosis, a palliative specialist might recommend a change in medications, music therapy and a monthly team re-evaluation as the disease evolves.
- For a child whose successful cystic fibrosis treatment causes shortness of breath, sleep problems and anxiety, a palliative care specialist might suggest additional medications, play therapy and relaxation techniques.
- For a patient whose Stage III liver cancer is responding poorly to chemotherapy, the palliative team might facilitate a family conversation about the risks and benefits of pursuing or stopping aggressive treatment. The result: A living will and care plan that spell out what the patient wants—and does not want—as the end of life nears.
Common Conditions for Palliative Care
Common diagnoses or conditions that can trigger a recommendation for palliative care include:
- Chronic lung disease that makes breathing difficult, even at rest and with oxygen support
- End-stage heart failure, with symptoms that linger despite treatment/therapy
- Debilitating stroke
- Cancer that has spread beyond the original tumor/site
- End-stage liver failure, kidney failure or multi-system organ failure
- End-stage HIV/AIDS that does not respond to anti-viral treatments
- Advanced dementia, marked by inability to communicate, inability to swallow, and dependence on others for most activities of daily living
Symptoms and Issues Palliative Care Can Address
Loss of appetite
Cultural issues and preferences
Family conversations about goals of care
Medical insurance issues
Spirituality and faith
More Benefits of Palliative Care
Think of palliative care as a consultative service provided by specially trained doctors, nurse practitioners and nurses. They provide an extra layer of support between the patient/family and other members of the healthcare team, such as the primary care physician, specialist, hospital physician, case manager, therapist, dietitian and others.
Palliative intervention coordinates and guides care toward agreed-upon goals and outcomes for symptom relief, patient comfort and quality of life. Benefits can include:
- Fewer hospitalizations
- Shorter stays when patients are hospitalized
- Fewer trips to the emergency department
- Optimal use of medical resources
- Better quality of life.
Patients who receive palliative care are also less likely to die in a hospital. In turn, hospitals, physician groups and medical facilities enjoy lower mortality rates and higher satisfaction scores from patients and their families.
Palliative Care vs. Hospice Care
A key difference between palliative and hospice care is that curative treatments are often incorporated into a patient’s palliative care plan, while hospice care does not include curative treatments. Hospice is limited to patients whose healthcare provider has determined they have a life expectancy of 6 months or less if the disease follows a natural course. Some palliative care patients are expected to improve and live long-term with a serious condition. Others eventually may be eligible for hospice care.
Palliative physicians, nurse practitioners and nurses typically become involved if a patient’s diagnosis is serious enough to require goals-of-care (GOC) conversations among patient, family and the healthcare team about end-of-life care options, preferences and goals.
Who Pays for Palliative Care?
Coverage for palliative care is governed by each patient’s health plan, and is subject to the same contributions and deductibles as other medical services or specialties. By contrast, hospice care is covered 100% by Medicare, Medicaid and most private plans.