What is palliative care?
Palliative Care (pal-lee-uh-tiv care) is medical care focused on improving quality of life for patients and their families. A key emphasis is managing pain and other symptoms such as nausea, sleep problems, and so on. Palliative care also focuses on improving planning and communication among the care team (patient, family, and medical staff), and addressing emotional and spiritual needs.
Palliative care can be given at different levels:
- Primary palliative care is woven into regular hospital care. It’s part of what your doctor, nurses, and other care providers do every day to control your pain and help you feel more comfortable. It can include talking about your diagnosis, your treatment options, and your plans for the future. It may mean finding emotional or spiritual support for you or your loved ones.
- A palliative care consult is specialized medical care for people with serious illness. It brings in providers with advanced training to partner with you and your other doctors and nurses. The team can provide extra support for treating complex symptoms, easing your physical pain, and helping you and your family manage the stress of hospitalization and illness.
Palliative care can be used alone or given along with curative measures that aim to treat illness or prolong life (antibiotics, surgery, radiation, etc.). At all levels and stages, palliative care is about improving the quality of a person’s life and supporting the decisions that she or he makes about care.
Is palliative care the same as hospice?
No, the two are not the same. Hospice and palliative care both focus on quality of life, and a person receiving hospice services will receive palliative care (pain management, emotional support, and so on). However, the use and scope of hospice is limited to the end of life. Here are some points illustrating the difference between palliative care and hospice:
- You can receive palliative care at any stage of life, and even for many years at a stretch. Hospice care is reserved for people who are not expected to live longer than 6 months.
- Palliative care can be given temporarily, to people who will go on to recover. Hospice is specifically focused on comfort at the end of life.
- Palliative care may be combined with treatment designed to cure illness or prolong life. A person receiving hospice services does not receive this type of medical treatment.
What can I expect from a palliative care consult?
A palliative care consult in the hospital can support your care in all areas. The consult can take many forms, but in general you can expect the following:
- Team-based approach. The team will include you and your family, your current doctor and care providers, and specialists in palliative care.
- Specialized knowledge and experience. Palliative care specialists can address the more complex problems that come with a serious illness. They serve as resources for the rest of the team.
- Improved coordination and communication. As you probably know, a medical problem can make life complicated. A palliative care consult can help make your care — and your life — more organized and less confusing. For example, while you’re in the hospital the team can help arrange for healthcare and other services you might need once you leave.
- Alignment with your desires and priorities. A consult gives you and your family a chance to reflect on your goals. It can also help ensure that the care you receive matches your current needs and values. Your palliative care team will never assume to know what kind of care you want — the team will talk in depth with you and your family to make sure you are guiding care at every point.
Having a completed Advance Directive helps to guide this descussion and any decisions that are made.
- Focus on quality of life in all areas. Your life is more than your medical problems or your treatment. From practical concerns to spiritual needs, a palliative care team can help you and your family feel less overwhelmed. You can focus on what’s most important to you.
Is it covered by insurance?
Many health plans, including Medicare and Medicaid, cover palliative care services in the hospital, but you should check with your insurance company. Ask about your coverage in the hospital and as an outpatient.
Who is on a palliative care team?
To form your palliative care team, people with special training and certifications will work with you and your current doctor and other providers. Each team member plays a different role, and you may meet with one or several of these specialists:
- Physician specialist: This doctor has received specialized training in palliative care after medical school. This doctor may have even completed a fellowship in Palliative Care or be Board Certified. He or she can serve as a resource to your other doctors about the best course of treatment and help ensure that you understand your condition and are involved in care plans.
- Nurse practitioner or registered nurse: This person may be the first member of your palliative care team you meet. With special training in palliative care, this team member can help with goal setting, family meetings, advance care planning, and any other needs. A nurse practitioner may have expanded responsibility for medication and symptom management.
- Social worker: A palliative care social worker is licensed in social work and has training to help meet the social and psychological needs of patients and families. She or he can also help coordinate care and manage transitions from one care setting to another.
- Chaplain: The chaplain’s work focuses on spirituality, not religion, and on helping you and your family begin to find meaning in your experience. He or she is trained to help with the nonphysical aspects of your care.