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Palliative Care, Medicine’s Best Kept Secret

 

The American population is aging, is living with complex chronic illness, and the demand for Palliative Care is growing. Unfortunately, many patients struggle to access palliative care and many Americans are not aware of what Palliative Care or have misconceptions about what it is.  So heere’s everything you need to know about Palliative Care, medicine’s best kept secret.

 

What is Palliative Care?

Palliative Care is a type of medical care to improve the quality of life, comfort, and resilience of seriously ill patients as well as their families. Seriously ill patients are those with life-threatening illnesses like cancer, organ failure, or dementia that negatively impact the life of the patient as well as causing tremendous stress for the caregiver. Importantly, Palliative Care can be provided at any age, stage of illness, prognosis, or treatment choice, and can be provided together with life-prolonging and curative treatment. You don’t have to choose between treatment for the illness and palliative care, you can have both.

Palliative care is provided by an interdisciplinary team of physicians, nurses, social workers, and chaplains to assess and manage the physical, psychological, social, and spiritual stressors associated with serious illness. Palliative care can be provided both in-person and through telepalliative care by palliative care specialists working with health systems, home health agencies, and private companies.

 

How Can Palliative Care Help?

A Palliative Care specialist can help in several ways:

  1. Assess & Manage: poorly controlled symptoms
  2. Understand: your illness, expected trajectory, treatment options.
  3. Explore: your hopes, wishes, worries,
  4. Identify: your goals, your values, what’s most important to you
  5. Discuss and Document: your advance care plan, advance directives such as a health care proxy, and preferences regarding medical treatments at the end-of-life.

Examples

For someone living with cancer, a palliative care specialist will collaborate with the cancer doctor to help manage pain caused by cancer as well as managing the side effects of treatment – such as nausea, vomiting, constipation. They can also help in identifying what is most important to the patient, what their goals and values are, and make sure to align treatment choices with these goals. Importantly, the palliative care specialist can help the patient AND their loved ones cope better with the anxieties and stress of illness.

For someone living with dementia, the palliative care team will help manage symptoms of confusion or agitation as well as harnessing community resources such as home health aids or a visiting nurse to support the caregiver. The palliative care specialist can also help the caregiver anticipate what could arise in the setting of dementia and help them think through a plan for the future.

 

Palliative Care Improves Lives

Palliative Care improves the quality of life of patients and their families by reducing mental and physical distress and discomfort. It has also been shown to help patients live longer. The prolonged survival is thought to be due to improved quality of life, appropriate administration of disease-directed treatments, and early referral to hospice for intensive symptom management and stabilization. And most people that got palliatve care would recommend it to others!

 

Palliative Care Is Not Hospice Care

Palliative Care and Hospice Care share a similar overarching philosophy; however they are distinct services. In the US, hospice care is provided to patients near the end of life, with a high risk of dying in the next six months and who will no longer benefit from or have chosen to forego life prolonging or illness related treatments. In choosing Hospice Care, the focus changes from life-prolonging medical treatments to comfort-focused medical treatments. Importantly, Hospice care neither hastens nor prolongs the dying process, instead it optimizes the quality of life for the time remaining. Learn more about the differences between Palliative Care and Hospice Care.

 

Is Palliative Care for me?

If you’re not sure if palliative care is right for you, sign up for Aging & Illness coaching and learn more about palliative care and if it could benefit you or a loved. 

Ashwini Bapat, M.D. is a palliative care doctor, coach, and co-Founder of EpioneMD. She completed her Internal Medicine residency and Hospice & Palliative Medicine fellowship at Yale-New Haven Hospital and then worked at Massachusetts General Hospital and Harvard Medical School. She loves using her insider knowledge to empower you to get the most out of your healthcare. 

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