Comfort care; End of life - palliative care; Hospice - palliative care
What it is
The goal of palliative care is to help patients with serious illnesses feel better. It prevents or treats symptoms and side effects of disease and treatment. Palliative care also treats emotional, social, practical, and spiritual problems that illnesses can bring up. When patients feel better in these areas, they have an improved quality of life.
Palliative care can be given at the same time as treatments meant to cure or treat the disease. You may get palliative care when the illness is diagnosed, throughout treatment, during follow-up, and at the end of life.
Palliative care may be offered for people with illnesses, such as:
- Heart disease
- Lung diseases
- Kidney failure
- ALS (amyotrophic lateral sclerosis)
You do not need to give up your doctor or your treatments to get palliative care.
Who gives palliative care?
Any health care provider can give palliative care. But some providers specialize in it. Palliative care may be given by:
- A team of doctors
- Registered dietitians
- Social workers
- Massage therapists
Palliative care may be offered by hospitals, home care agencies, cancer centers, and long term care facilities. Your doctor or hospital can give you the names of palliative care specialists near you.
The difference between palliative care and hospice
Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the patient is not going to survive the illness.
Hospice care is usually offered only when the person is expected to live 6 months or less.
What does palliative care include?
A serious illness affects more than just the body. It touches all areas of a person's life, as well as that person's family members' lives. Palliative care can address these effects of a person's illness.
Physical problems. Symptoms or side effects include:
Treatments may include:
- Nutritional guidance
- Physical therapy
- Occupational therapy
- Integrative therapies
Emotional, social, and coping problems. Patients and their families face stress during illness that can lead to fear, anxiety, hopelessness, or depression. Family members may take on care giving, even if they also have jobs and other duties.
Treatments may include:
- Support groups
- Family meetings
- Referrals to mental health providers
Practical problems. Some of the problems brought on by illness are practical, such as money- or job-related problems, insurance questions, and legal issues. A palliative care team may:
- Explain complex medical forms or help families understand treatment choices
- Provide or refer families to financial counseling
- Help connect you to resources for transportation or housing
Spiritual issues. When people are challenged by illness, they may look for meaning or question their faith. A palliative care team may help patients and families explore their beliefs and values so they can move toward acceptance and peace.
What to do
Tell your doctor what bothers and concerns you most, and what issues are most important to you. Give your doctor a copy of your living will or health care proxy.
Ask your doctor what palliative care services are available to you. Palliative care is almost always covered by health insurance, including Medicare or Medicaid. If you do not have health insurance, talk to a social worker or the hospital's financial counselor.
Byock I. Principles of palliative medicine. In: Walsh D, Caraceni AT, Fainsinger R, et al, eds. Palliative Medicine. Philadelphia, PA: Elsevier Saunders; 2008:chap 7.
Eti S. Palliative care: an evolving field in medicine. Prim Care Clin Office Pract. 2011;38:159-171. PMID: 21628032 www.ncbi.nlm.nih.gov/pubmed/21628032.
Update Date 5/11/2014
Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.