Palliative Care Overview

A comprehensive medical team will guide you through any chronic disease

Should you seek palliative care? If you’re one of the approximately 90 million Americans coping with a life-threatening or chronic illness, it’s worth exploring, as the Center to Advance Palliative Care estimates that six million people in the United States could benefit from its services. While a fairly new field, demand for—and access to—palliative care has grown as the US population ages and as more people live with chronic conditions.

What is Palliative Care?

Unlike many medical specialties, palliative care does not treat a specific condition or illness. Instead, palliative care helps relieve the symptoms and stress that often accompany any type of serious or long-term illness. Palliative care involves a personalized approach that depends on a patient’s needs.

“Examples of palliative care include assisting patients with pain relief, sleep quality, gastrointestinal symptoms such as nausea, vomiting and constipation, and even with helping them breathe easier,” explains Jeff Gudin, MD, director of Pain and Palliative Care at Englewood Hospital and Medical Center in New Jersey and an Editor-at-Large of PPM. “It also often includes stress reduction, relaxation, and meditation techniques. Palliative care practitioners are trained to support the family during and after the patient’s illness.”

While anyone with a complicated or chronic condition can benefit from palliative care, it’s most commonly seen among patients with heart disease, cancer, stroke, and diabetes, as well as those with renal, Parkinson’s and/or Alzheimer’s disease.

Palliative care can be delivered in hospitals (about two-thirds of US hospitals have palliative care units), at outpatient clinics, or in the home. Services are provided by a team of health professionals, including doctors, nurses, social workers, dieticians, physical therapists, and others.

Palliative CareOften misinterpreted as hospice care, palliative care looks to effectively manage symptoms and improve life with chronic conditions. (Source: 123RF)

Misconceptions and Benefits

Palliative Care is Not Hospice Care

Palliative care is often confused for or misunderstood as hospice care, and while the goals of both palliative and hospice care are the same—increased comfort and better quality of life—the patients are different. Hospice care, for the most part, focuses on helping patients who are not expected to survive their illness and/or are no longer being treated. In contrast, palliative care patients receive therapies to manage their conditions, often vastly improving them.

“Patients and their families need to recognize that palliative care is not synonymous with ‘end-of-life’ or hospice care, and that our services are meant only to improve the quality of life for those with advanced illness,” Dr. Gudin notes.“Often, patients or family members put off palliative care because they think it may hasten death, [but] it’s just the opposite,” he says. “Patients who are relieved of their symptoms usually live longer!”

In fact, several studies have found that cancer patients who received early palliative care survived longer than those who did not. Palliative care often leads to shorter hospital stays, improved quality of life, reduced symptom frequency and severity, and better strategies to relieve pain for the elderly population.

Palliative Care Serves any Age Group

In addition, while many people who receive palliative care are older, patients of any age can benefit from it. For instance, multiple sclerosis patients—most of whom are diagnosed between the ages of 20 and 50—often receive palliative care. Children dealing with chronic conditions like cerebral palsy and blood disorders may also receive palliative care.

Palliative Care is Costly

Whether you have private insurance, Medicare, or Medicaid, your palliative care team can help determine what services are covered, and to what extent. Dr. Gudin says that, in his experience, “most insurances cover at least basic medical services, if not all doctor visits and even some durable medical equipment.” In terms of cost-effectiveness, he noted that, “Early palliative care intervention cuts healthcare system costs while improving quality of care.”

Advance Care Planning

Patients with a serious or chronic illness may also choose to consider advance care planning, which is the process of thinking and making decisions about potential healthcare needs ahead of time, and then informing your loved ones and healthcare providers. An advance care plan usually involves a legal document called an Advance Directive, which will only take effect if you’re unable to verbally express your wishes. This document may map out specifics such as what medications, medical equipment, or treatments (like surgery or blood transfusions) to use or not use. In case of unforeseen complications, directives can also be set in place for living wills, power of attorney, and other important future planning. With an advance care plan in place, your care team will know exactly how to treat you.

 

Overall, a palliative care team works together to improve your health, working alongside you, your family, and your doctors. Improving your quality of life is their essential goal, and these teams are available to support you every step of the way.

Updated on: 10/29/18
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Is Palliative Care Right for Me?
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