Definition and Overview

The specialty of palliative care deals with the medical management of patients with serious, and usually chronic or terminal conditions. The primary goals of palliative care are to provide relief of the patient's symptoms and to improve the patient's quality of life, as well as that of his family. Palliative care is usually provided to address the symptoms of life-threatening diseases, as well as the complications of the treatment for the disease. According to the World Health Organization, suffering and pain is relieved and further prevented via early identification and evaluation of the patient's problems. Various issues are addressed; not only the physical, but also the emotional, psychological, social and even spiritual. Palliative care is also commonly called supportive care or comfort care.

Palliative care medicine is a multi-disciplinary specialty. A group of physicians, nurses, allied health care professionals and other specialists work hand-in-hand with the primary doctor to provide additional support to the patient and his family. It serves as an invaluable support system when dealing with any illness. With palliative care, the patient and his family are able to communicate with their physician better about the goals of treatment and their expectations. You will not have to give up your primary doctor; the palliative care team will coordinate and work together with your other physicians to ensure that all your symptoms and concerns are taken care of.

Palliative care may be given to any person, regardless of the age. It may also be given regardless of the stage or prognosis of the disease. Both hospice care and palliative care have the same goal of symptomatic relief; the major difference between the two is that hospice care is a form of management without intent to cure the disease, while palliative care may be given together with curative therapies. Palliative care may be offered to any patient with a complex disease, regardless of the outcome. Thus, it may be given whether the patient is expected to have the illness for a prolonged period of time, to fully recover eventually or to experience progression of the disease.

Palliative care has been shown to have significant benefits for the patient and his family. Research shows that patients are more compliant with their treatment when their emotional and physical concerns are adequately addressed. Patients who receive palliative care end up with a better quality of life and lower hospital expenses, since priorities of treatment are better identified, and unnecessary examinations are avoided.

When You Should See a Palliative Care Specialist

Palliative care used to be directed solely to patients with cancer, as an option for end-of-life care. Nowadays, it is increasingly being recommended for people who have chronic diseases, such as renal insufficiency, pulmonary diseases, neurological disorders, heart failure, and even immunocompromised conditions such as HIV and AIDS. Any patient with a serious disease or who develops any form of pain or distress may seek palliative care. It may be given to both adults and children. Palliative care may not only improve a person's quality of life, it may also assists in prolonging it.

In some instances, palliative care may be recommended as the sole treatment plan for a patient. In these cases, no curative treatment is rendered to the patient. These cases include patients who have limited performance capacity and functional status, resulting in a decreased capability to take care of one's self. It also includes patients who have attempted evidence-based treatments in the past but have been unable to get any benefit from them, and those who are not eligible or amenable to be included in any clinical trial.

If you are referred to a palliative care specialist, you will be evaluated and be asked regarding your symptoms. You will be required to provide information such as degree of your pain, appetite, feelings and emotions, and the general sense of well-being, among others.

The goal of your physician is to manage your overall condition. This begins by addressing your physical pain using pain relievers, such as opioids. You may also be given anti-psychotic drugs to manage other symptoms, such as nausea. In addition, physical therapy or focused exercises may also be recommended. Multi-modality treatment options, such as surgery, chemotherapy, and radiotherapy, may likewise be offered to shrink masses and minimize pain, depending on your symptoms.

Psychological and emotional issues will also be dealt with. Counseling and family meetings are usually recommended. You may also be referred to a mental health therapist or advised to join support groups for these concerns. Your social issues will likewise be addressed, with the assistance of other members of the palliative care team, such as a counselor or social worker. Other teams may also include a pharmacist, a dietician, and a chaplain, depending on the patient's and his family's needs.

The patient's family, who are prone to develop emotional, psychological and social issues because of the patient's illness, may also receive palliative care services. Palliative care can help ease their concerns and help them to cope with the situation.

Most medical institutions offer in-house palliative care services. Thus, it can be taken advantage of in a hospital or a cancer center where the patient is admitted. However, if the patient is not admitted, there are also options for palliative care outside the hospital. It may be given in facilities for long-term care, such as nursing homes and hospices, or even at the patient's home, under the supervision of the physician. Several palliative care programs also offer assistance regarding meal preparations, procurement of needs, and even respite care for family members and caregivers who need some time off.

There are several resources and national organizations that can give you more information on palliative care options, specifically in your community and locality. Palliative care services may be covered by health insurance.

References:

  • Centre for Palliative Care: https://centreforpallcare.org
  • National Palliative Care Research Centre: https://npcrc.org
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