Palliative Care 101

Posted December 09, 2018 by Melissa Soltis, M.D. Medical Director, Hospice/Palliative Care Summa Health

Palliative Care is specialized treatment tailored to those who are suffering from chronic or life limiting illnesses. Some of these illnesses may include cancer, kidney disease, heart failure, dementia, lung disease and many others. Palliative care is a specialized team of doctors, nurses, chaplains, social workers and others who work together with a patient’s primary physician and care team. The goal of the team is to improve the quality of life for a patient (and sometimes their caregivers) who has a serious illness or disease. It is appropriate for all ages and stages in a patient’s severe illness.

An entire team cares for a patient by helping with distressing symptoms, difficult treatment plans, and working to determine a patient’s goals for their care. Many patients with severe illnesses may experience symptoms that impact their quality of life. These symptoms can include pain, shortness of breath, nausea, depression, weight loss or anything else that is making daily living a challenge. Palliative care helps to create an individualized care plan to holistically address these secondary symptoms.

Palliative care may vary from one patient to another but generally encompasses a holistic care approach to treating all aspects of suffering:

• Mental suffering may be felt as depression, anxiety or grief related to a severe illness. Counseling, group therapy, individual therapy and even medications may be recommended. Psychology and spiritual care components are addressed with each patient by trained specialists on the team and a care plan is created with input from the care team.
• Physical suffering includes addressing loss of appetite, nausea, pain, shortness of breath, insomnia and other forms of physical discomfort. Massage therapy, physical therapy, meditation, and medication if appropriate may be used to help improve physical suffering.  
• Practical issues for those patients with severe and life limiting illnesses may include need for help with financial obligations, wills, insurance concerns and other matters for end of life care. There are many team members that can aid in this additional form of care, including family members, attorneys, social workers, and other caregivers.
• Caregiver support means just that, support for a caregiver. For family members who care for their relatives, the additional stress and mental health strain can be overwhelming. The palliative care team is able to provide group and individual support for family members both during an illness and following the death of a loved one. A grief recovery program is available to support those seeking additional help.  Social workers, psychologists, and chaplains are important team members available to provide these programs.  

When the above components of palliative care are incorporated into a patients’ care plan, the result is a comprehensive plan of care that focuses on quality of life. The care plan is holistically created with the patients goals at the center. For some patients, palliative care services may help to introduce them to hospice services as they eventually decline from their illnesses.

Palliative Care v. Hospice

Palliative care and hospice care both focus on the patient’s quality of life and can be performed in the home or at a facility. However, palliative care can begin as early as diagnosis and continues through recovery. Hospice care can only be provided once the patient’s disease is non-curable.  It is reserved for patients whom are determined by their physicians to have months rather than years.

For many, being able to transition from palliative care to hospice care is easier than moving solely from diagnosis and treatment into hospice care. By introducing a holistic approach to maintaining a quality of life during treatment, a patient may feel more prepared for physical changes that occur near the end of life and cope with their grief and emotions in a more positive way. Their caregivers may also feel more prepared.