Understanding Palliative Care & Its ValueFebruary 19, 2014
Patients facing serious, long-term illnesses usually require multifaceted aspects of care and this is what palliative care aims to address. The goal of palliative care is to improve quality of life for patients any point during their illness. This is irrespective of, and independent from their treatment plans. Achieving this requires an interdisciplinary team of professionals, which ranges from medical professionals such as physicians, nurses, pharmacists and physician assistants, to non-medical professionals such as social workers and chaplains.
Unfortunately, palliative care is often thought to be the same as end-of-life care and patients too often resist accepting it during the diagnostic process. The fact is palliative care is appropriate at any stage of serious illness. It simply focuses on improving the patient’s quality of life through management of symptoms and offering support for the patient and the patient’s family.
Today, with the better understanding of palliative care, early integration of palliative care is becoming the new standard of care, especially for patients with advanced cancer. Studies have shown that early integration, particularly at the time of initial diagnosis is more effective than the older philosophy of introducing palliative care at the later stages of a disease. At the early stage, palliative care focuses on symptom management and awareness of prognosis, which helps the caregiver create a more effective plan.
Also, with the better understanding of the value of palliative care, it is no longer limited to just cancer patients. Palliative care is also beneficial for patients with other chronic diseases such as advanced heart failure (HF), pulmonary hypertension, end-stage renal disease and severe chronic obstructive pulmonary disease (COPD). It is also beneficial for patients with neurodegenerative diseases such as Huntington disease and ALS or amyotrophic lateral sclerosis. Critically ill patients in the intensive care unit can also benefit hugely from consistent palliative care.
Patients with a serious illness have a number of symptoms that palliative care teams can address. Many symptoms other than pain affect the majority of patients who have chronic and severe illness. Dyspnea, nausea, fatigue, delirium and other troublesome symptoms can affect patients and their caregivers. By identifying and addressing these distressing symptoms, the palliative care team can temper their effect on the patients as well as their caregivers.
Palliative care also helps address the emotional impact of serious illness on patients and their families. In depressed terminally ill patients, palliative care teams can help make the distinction between preparatory grief and clinical depression thus facilitating earlier treatment of depression. The aggressive symptom management together with the psychological and spiritual support from palliative caregivers can improve the depressed patient’s mood. It is this combination of painstaking attention to both psychosocial distress and physical symptoms that is at the core of palliative care.
Palliative care enhances health care value. Consistent palliative care is associated with considerable reductions in the costs of pharmacy, laboratory, and ICU services. The palliative care team can improve a patient’s quality of life and mood, as well as enhance the satisfaction of both patient and family. As the number of people all over the world, living with serious and life-threatening illnesses continues to increase, palliative care is likely to play an increasingly significant role in providing higher quality health care at a lower cost.