Patients with serious illnesses, such as cancer, often suffer from more than just the physical symptoms of their disease. They may struggle emotionally and deal with depression and anxiety.
Palliative care can offer an “extra layer” of treatment to help patients experience a better quality of life. Also called comfort or supportive care, it is designed to treat the whole person.
Palliative care can be given at any time during progression of a disease. But Dr. Helen M. Gordon, director of palliative care at University of Maryland St. Joseph Medical Center, said she wishes it was offered earlier to people and not just in the late stages of illness.
Palliative care is specialized medical care for patients with serious illness to help them manage physical and emotional symptoms from the illness and its treatment. It is an extra layer of care that helps focus on quality of life. It is offered to treat and target the symptoms of a chronic or progressive illness, relieve the side effects of treatment, provide comfort and improve each patient’s quality of life.
How is palliative care different than hospice care?
Hospice care is the care given when aggressive treatments to prolong days are no longer working, or the burden of them is too great and the patient and family choose to shift focus to day-to-day quality and comfort. Hospice care means that the disease is expected to be fatal in the coming days, weeks or months, and all the treatment is just focused on comfort. There is a team supporting that patient to live as well as possible in the time there is, usually at their home, and to make sure that he or she has a peaceful death when the time comes, and that the family is well supported.
Palliative care often starts when a diagnosis is first made, and aggressive treatments are being used. Palliative care helps with symptom management of the disease and of the side effects of treatments. When, and if appropriate, it also helps with the transition to hospice care.
Why do specialists and oncologist refer patients to palliative care?
Being referred to a palliative care specialist does not mean a patient is being referred for hospice care. The patient’s specialist or oncologist may be hoping for many years of life for that patient, or even a cure, but they see suffering from the treatment and want an extra layer of support.
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Patients who qualify for palliative care include those with:
Stage 3, stage 4 or recurrent cancer;
Progressive neurological disease, such as progressive supranuclear palsy, Parkinson’s disease or ALS;
Progressive lung disease needing oxygen or who have frequent exacerbations or hospitalizations;
Progressive cardiac disease, such as congestive heart failure or aortic stenosis;
Progressive dementia or frailty;
A serious illness;
Undue suffering related to medical conditions
When does palliative care typically begin?
Unfortunately palliative care referrals, like hospice referrals, often come late in the disease process, when there is little time remaining to help a patient enjoy what time they have left because they are close to dying. Early referral lets patients and families talk about what is most important, find some peace and closure, and spend quality time together.
Is palliative care always given in an in-patient setting or can it be provided at a patient’s home?
Most palliative care teams work in hospitals, but there also are outpatient clinics and some home care available. Multi-disciplinary palliative care teams at UM St. Joseph Medical Center are comprised of physicians, nurse practitioners, physician’s assistants, registered nurses, social workers, chaplains and pharmacists.