What is Palliative Care

    Kristine Hays, RN, BSN, Palliative Care Consult Nurse

    As defined by the Center to Advance Palliative Care: Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illnesses. It is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis.  The goal of palliative care is to relieve suffering and provide the best possible quality of life for people facing pain, symptoms and stresses caused by illness. This service improves quality of life for both the patient and the family.

    Palliative care is provided by a team of doctors, nurses, and other specialists who work together with a patient's other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

    Some of the most common concerns for palliative care patients and their families are:

    • Symptom management, such as pain, nausea, vomiting, anxiety/depression, dyspnea (difficulty breathing), constipation, diarrhea, confusion, agitation, etc.
    • Improving quality of life issues, such as activity level, social involvement, stress…. Helping make life enjoyable
    • Goals of care, such as how aggressively they want to treat their disease.  For example, does a  patient want to seek a cure, or are they more interested in their quality of life and comfort?
    • Helping patients develop an advance directive/living will/power of attorney.

    Deaconess Palliative Care can help anyone who is suffering from a serious illness. It does not necessarily mean that the illness is terminal when you’re receiving palliative care. It means that the condition and its symptoms are significant and should be treated for both comfort and effectiveness.

    The benefits of palliative care are for the patient and their family/friends alike. Palliative care is a partnership of patient, medical specialists and family. Usually a team of experts, including palliative care doctors, nurses and social workers, provides this care and works together with your own doctor. Massage therapists, pharmacists, nutritionists and others may also be part of the palliative care team.

    The team supports you and your family every step of the way, not only by controlling your symptoms, but also by helping you to understand your treatment options and goals. Working with your doctor to provide an extra layer of support, the palliative care team provides:

    • Time for close communication
    • Expert management of pain and other symptoms
    • Help navigating the health care system
    • Guidance with difficult and complex treatment choices
    • Emotional and spiritual support for you and your family

    Conditions that are commonly treated with palliative care options include serious and chronic illnesses including cancer, cardiac disease such as Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), kidney failure, Alzheimer's, HIV/AIDS and Amyotrophic Lateral Sclerosis (ALS—aka Lou Gehrig’s disease).

    A difference between hospice and palliative care is that hospice is palliative care for people with a terminal illness who have 6 months or less to live, and who have chosen not to aggressively fight their disease or seek a cure. Palliative care patients are seen at any stage of their disease, regardless of their treatment choices.

    Following are some tips to help you talk to your physician (from CAPC):
    • Tell your doctor you are considering palliative care and ask what palliative services are available in your area.
    • Ask your doctor to explain your illness as well as past, current, and future treatments and procedures.
    • Explain to your doctor what quality of life means to you. This list may include:
      • being able to spend time with loved ones
      • treating pain and other distressing symptoms aggressively
      • maintaining the ability to make your own decisions for care and your preferred location of treatments (home vs. in the hospital)
    • Be sure your doctor is aware of any personal, religious, or cultural beliefs, values, or practices that are important to consider in your care and treatment decisions.
    • Tell your doctor what curative treatments you may or may not want, such as resuscitation if your heart were to stop, being placed on a mechanical ventilator if your lungs were to fail, undergoing dialysis if your kidneys were to fail, and artificial nutrition by a feeding tube if you were unable to eat.
    • If you have completed a living will or health care proxy, be sure to inform your doctor and provide him or her with a copy.
    • If you are suffering with pain and other symptoms due to a serious illness, ask your doctor for a palliative care referral.

    The overall benefits of palliative care are numerous. 
    • Palliative care treats the whole person by offering medical, emotional, spiritual and social support.
    • Palliative care makes patients feel better throughout their illness by treating pain and symptoms such as shortness of breath, loss of appetite, fatigue, constipation and difficulty sleeping.
    • Palliative care helps patients and families understand the illness and choices for care.
    • Palliative care offers guidance and support with difficult medical decisions.
    • Palliative care helps with communication with medical staff.
    • Palliative care eases transitions between health care settings. 
    In conclusion, palliative care can help you take back control of your life.
    Posted: April 11, 2014 by Pam Hight

    Tags: end of life care, pain, palliative, serious illness

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