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What Is Palliative Care?

Posted on Feb 2, 2016 in Prevention and Wellness

 

CaringHands

Palliative care is a medical specialty that helps people who are facing a serious health crisis, whether chronic or terminal, at any stage. The word palliative comes from the Latin verb “palliare,” which means to put a cloak around someone — a simple gesture offering physical comfort and support.

“In the purest sense, the concept of palliative care is to be present, attentive and emotionally supportive, physically providing comfort and accepting a person for who and where they are,” says Suzanne Pertsch, M.D., medical director of Palliative Care at Mills-Peninsula.

Difficult Conversations
A palliative care consultation typically begins with a discussion with the sick person and his or her family to clarify the person’s wishes and goals of care, talk about the illness trajectory and prognosis, explore options for care and the need for pain management, and discuss other aspects of care that affect a person’s quality of life.

Depending on the severity of illness, palliative care teams also help families sort through questions about who will provide care, how to choose a surrogate decision-maker if needed for the future and how to fill out paperwork, such as an advance directive or a POLST (Physician Orders for Life- Sustaining Treatment) form.

“These conversations are not easy to have, but they need to happen and most patients and families want this information,” says Sharon Tapper, M.D., palliative care medical director at the Palo Alto Medical Foundation. “Most patients and their families know when they are getting sicker. They want to know their choices so they can make informed decisions.”

It’s a team effort — palliative care programs typically include a board-certified palliative care doctor, a nurse practitioner, a social worker, a care coordinator, a chaplain, a physical therapist and others with specialized training.

Dr. Pertsch describes a typical palliative care consultation: talking to a person who has just been diagnosed with advanced cancer.

“People and families are often reeling from rapid changes and aren’t ready to accept what is happening,” Dr. Pertsch says. “Our team helps them assimilate the information and come to terms. We break it down to the basic concerns — what are your options, what is meaningful to you — and provide psychological and social support as needed.”

Powerful Medicine
A three-year study published in 2010 by The New England Journal of Medicine suggests that palliative care is powerful medicine. The study found that people with advanced lung cancer who received palliative care early after diagnosis along with cancer treatment lived more than two months longer. They also experienced less clinical depression and a better quality of life than those who received treatment alone.

A misconception about palliative care is that it consists of end-of-life comfort care only.  Although often paired with hospice, which is defined as care in the last six months of life, palliative care can be used to aid treatment for any serious health issue at any point in life and can be provided in conjunction with curative treatment.

“Making that choice to pursue palliative care does not mean you’ve given up,” says Deborah Griffith, whose husband Jeffery received palliative care before passing away from cancer in 2015. “You’ve chosen to live another way and some of that way is without fear. Palliative care provides the physical and emotional support you need. It was exactly what he needed to be comfortable and at peace.”