Palliative medicine & its role in patient care

It was not too long ago when a heart attack and cancer diagnosis were considered fatal. Today, however, when more caregivers and families are taking the approach of caring for the whole person – and not just the disease – those experiencing illness and suffering are able to find comfort and support. This is where Palliative Medicine has its place.

Palliative Medicine grew out of the Hospice ideology, which is used when a cure is not possible, but a managed, end of life plan needs to be in place. The federal guidelines for Hospice enrollment suggest that a lifespan of six months would be appropriate for this kind of care. This time frame is not set in stone, and many times patients sometimes live longer. If they do exceptionally well, they may even “graduate” from Hospice because their need for end of life care is not as imminent.

Palliative Medicine goes one step further by encouraging a plan of care which addresses symptoms and creates goals consistent with a patient’s emotional, physical, spiritual, financial and medical needs. These efforts are most effective when disease becomes serious, complex, or life limiting, not when it becomes invariably fatal.

Also similar to Hospice, the focus of Palliative Medicine is “the family.”

Diseases do not exist in isolation. Illness is a personal reality affecting more than the ailing individual. It is part of the human condition, and so when illness interrupts lifestyle, it becomes part of the total human condition.

Illness, just like the weather, has its seasons. When you add increasing financial pressures and impossible expectations, patients and families often need help with their decision making. This is where Palliative Medicine can help.

Diseases are dynamic and change day to day. While there may be times when disease is still treatable, it also can be devastatingly painful. Long before cancer might cause death, it can cause suffering, and in reality, many times the therapies used to treat cancer can cause suffering as well. Again, bringing Palliative Medicine into the treatment of an illness can ease some of the burden.

Many assume that Palliative Medicine is limited to cancer. However, patients with chronic diseases such as COPD (chronic obstructive pulmonary disease), CAD (heart disease), dementia, Parkinson’s Disease, and Crohns Disease also benefit from Palliative care.

Most programs begin in the hospital setting, particularly for patients who seem to return consistently or fail to improve. This may be a valuable service for families and patients who need to be better informed so that they can make better decisions. Many times the Palliative Medicine team is the first to ask if the patient or family has a full understanding of what is happening.

Most hospitals today offer Palliative Care Consultations, and you and your doctor can decide if it might be good thing. Here are three things that will happen if seek a consultation:

1) You will be listened to
2) Your symptoms will be managed with a high skill level
3) Your family will be supported emotionally and socially

With a primary goal of advocacy for the patient, Palliative Care aims for dignity and honesty in establishing a care plan which reflects the patient’s needs and provides for it with skillful medical and behavioral methods to enhance the lives of patients and those who care for them.

Written by
Arlene Bobonich, MD, PinnacleHealth Palliative Care

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