What Is Palliative Care?by James Ryan, D.O. As a family practice physician, one of my responsibilities is to develop a lifelong relationship with my patients, treating them—or providing referrals for them—throughout the course of their lives. The relationship building is one of the things I like best about serving patients and a large part of why I chose family practice medicine.
One issue I see many patients struggle with is palliative care. Palliative care is care given for the sake of managing pain and providing comfort for patients. It can be given at the same time as other therapies that treat diseases such as cancer or heart disease. Or, palliative care can be given on its own if a patient has a terminal illness.
A Team-Based ApproachDoctors, nurses, social workers, physical therapists, dietitians, chaplains, and volunteers all may contribute to palliative care. Our goal is to enhance the patient’s quality of life. To do this, we may use pain medicine to ease distress. We also may address other symptoms that cause discomfort, such as nausea, difficulty breathing, or extreme fatigue.
One type of palliative care, called hospice care, focuses on helping patients at the end of life. Those receiving end-of-life care benefit from pain and symptom management, as well as emotional and spiritual support. Hospice caregivers can help patients take care of “life business,” such as mending relationships, in the final stage of their lives. Grief counseling is available to families and friends.
Comfort and Care in the HospitalPalliative care can be provided anywhere, such as at home, in a nursing home, or in a hospital setting. In a hospital setting, palliative care involves pain management and support to inpatients and their families. Physicians and discharge planners can also help patients and family members plan what palliative care they will need when they return home or go to another facility and can communicate those wishes to the facility. Plus, they can support families coping with difficult end-of-life issues in the hospital. This may include decisions to end ventilator support or artificial feeding.
It is important for caregivers to know the wishes of their loved ones regarding endof- life care. Don’t wait until it is needed to have these conversations. Durable power of attorney forms for health care should be completed by caregivers and put on file so that the wishes of your loved ones are known in advance and can be carried out.
Choosing Palliative CareWhen deciding about palliative care, it can be helpful to ask your physician questions such as these:
- What types of medicines do you usually prescribe for pain?
- What about nonmedical or alternative therapies?
- Who will provide the care?
- How will the family be involved?
These questions and decisions are difficult for families struggling with the emotional issues of an ill or dying loved one. My recommendation is to write down your questions before seeing your physician so that you’ll remember what you want answered. You should feel comfortable discussing all aspects of medical care with your family physician, even difficult issues such as palliative care.