Palliative care is specialized, supportive care for people with serious
medical conditions and focuses on providing relief from the symptoms and
stress associated with serious illness. Palliative care is patient and
family centered care, delivered by a team of professionals. The core of
the palliative care team includes physicians, nurse practitioners, registered
nurses, social workers, pharmacists, and chaplains. Palliative care is
not merely end of life care but can be included at any phase of treatment
and would, ideally, began at the diagnosis of a serious or life-threatening
illness and continue throughout the disease process.
Palliative care focuses on the physical, psychological, social, and spiritual
aspects of care, with an emphasis being given to the cultural needs, values,
beliefs, preferences, and wishes of the patient and the family. The palliative
care team works to keep the patient informed and educated on the disease
process and treatment options, which allows the patient to choose the
care and treatment most compatible with the patient’s goals of care.
The palliative care team assists the patient in making choices which maximize
the patient’s quality of life, as defined by the patient. That is,
many patients prefer options which may sacrifice longevity of life, in
favor of a higher quality of life.
Typical palliative care referrals involve patients who have been diagnosed
with diseases such as cancer, heart disease, lung disease, kidney failure,
dementia, stroke, HIV/AIDS, and ALS. However, the palliative care team
can be helpful for any patient who has been diagnosed with serious, life-threatening
illnesses.
Goals of Palliative Care
While the goals of palliative care will be different for each patient,
the overarching goal of the palliative care team is to maximize the quality
of life for the patient and family. Palliative care focuses on the physical,
mental, emotional, and spiritual needs of the patient and family. The
palliative care team works with the patient to prevent and treat symptoms
of the disease and side effects of treatment, such as pain, shortness
of breath, fatigue, constipation, nausea, loss of appetite, difficulty
sleeping, and depression. Studies have shown that patients and their families
are more satisfied with patient care and that patients achieve a higher
quality of life when palliative care is involved.
The palliative care team also frequently engages patients and their support
teams in advance directive conversations to ensure that the medical care
being delivered is consistent with the wishes of the patient and also
to ensure that the patient’s support system is aware of the patient’s
wishes regarding care. One of the most precious gifts anyone can give
is making their loved ones aware of their wishes regarding end-of-life
care, as this relieves those loved ones from the burden of making difficult
end-of-life decisions for their loved ones.
Palliative Care Compared to Hospice Care
Both palliative care and hospice care provide comfort measures for the
patient and family. Hospice care has been around for a long time, with
the goal of caring for and keeping patients comfortable after treatment
efforts have been exhausted. Hospice care focuses simply on providing
comfort during end-of-life care and generally involves patients with a
life expectancy of six months or less and for whom cure is no longer an option.
Palliative care, in contrast, addresses the care and treatment of a much
broader range of patients, including those patients who are only at the
beginning of their journey with a serious, life-threatening illness. The
palliative care team involved with the patient and the patient’s
support system throughout the course of the illness, can assist the patient
with informed decision-making that maximizes the quality of life and patient
autonomy. Palliative care differs from hospice in that palliative care
can be utilized along with measures which involve aggressive treatment
of a disease.
Contact the Palliative Care Team Today
The palliative care team consists of an interdisciplinary and dedicated
group of health care professionals working together to meet the goals
of our patients and families.
Jonathan T. Miller, MDInternal MedicineDiagnostic & Medical Clinic 1700 Springhill Avenue
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