Palliative care is largely unfamiliar to the general public, occasionally misunderstood in the medical community, and often used synonymously with hospice care, which leads to confusion about both services. It is important for all of us to understand palliative care, as it is both an essential approach to caring for individuals living with serious illnesses and an indispensable component to the sustainability of our health care delivery system.
Benefiting Individuals with Serious Illnesses
The Center for the Advancement of Palliative Care defines palliative care as “specialized medical care for people with serious illnesses.” While there is some variability in palliative care services based on geography and setting, palliative care is a team approach which can include a physician, nurse practitioner, nurse, social worker, and chaplain. Palliative care teams are specially trained to manage intractable pain and other bothersome symptoms that include but are not limited to physical pain, dyspnea, nausea, delirium, restlessness, and constipation. Additionally, palliative care teams bring expertise in addressing emotional and spiritual distress. Furthermore, palliative care providers are experts in communicating effectively with patients and families about prognosis and facilitating family meetings aimed at defining quality of life and goals of care for the patient to ensure that additional treatments are concordant with a patient’s values, preferences, and goals.
Palliative care is a consultation service, which means that for a seriously ill individual to access a palliative care specialist, a referral must be made by a physician. While most palliative care services are provided to patients while in the hospital, palliative care may also be available in long-term care facilities, outpatient clinics, and in an individual’s home. It is important for caregivers of individuals living with serious illness to ask health care providers about available palliative care services in the area.
Palliative Care vs. Hospice Care
It is often said that all hospice care is palliative care but not all palliative care is hospice care. While this is true, the saying does little to clarify the distinction. To receive hospice services, an individual must have a terminal illness, meaning that person is typically in the last six months of life. Two physicians must certify that a patient has a terminal illness. Additionally, once a terminally ill individual elects to enroll in hospice care, all treatments for the terminal diagnosis are palliative rather than curative, meaning treatments are aimed at making an individual comfortable and improving quality of life.
Unlike hospice care, palliative care services are available to anyone with a serious illness in need of pain and symptom management. Moreover, palliative care services can be provided concurrently with curative treatments.
Aiding our Health Care System
Palliative care is not only beneficial for patients and families, but it is also an efficient use of our health care dollar. There are three recurring themes in much of the research on palliative care: 1) Palliative care improves the quality of life of individuals living with serious illnesses; 2) Palliative care keeps health care costs minimal through goals of care conversations that eliminate both unnecessary trips to emergency departments and hospitals and that reduce treatments and testing inconsistent with patient preferences; and 3) Palliative care prolongs survival in individuals with serious illnesses. In short, palliative care teams provide an interdisciplinary, patient-centered approach to pain and symptom management that benefit patients, caregivers, and our health care delivery system. As our health care system evolves to meet the needs of an aging population, the need for palliative care becomes all the more salient.
The Palliative Care Center of the Bluegrass provides consultative services in many Central Kentucky hospitals and long-term care facilities as well as an outpatient clinic. For more information call (859) 278-4869.