Palliative Care: Putting Patients at the Center of Health Care Decisions

What are Palliative Care and Hospice Care? - UnityPoint

Palliative medicine is a relatively new specialty of less than 20 years. If you haven’t heard of it, you’re not alone. Being aware of it as you and your loved ones age can ensure the medical care you receive is what you really want. David Nordstrom, MD, UnityPoint Health explains the benefits of palliative care.

What is Palliative Care?

Palliative care is medical care for patients with serious or life-limiting medical conditions. This type of treatment involves a holistic approach to patients’ conditions. The focus is on education, comfort, symptom management and quality of life by managing symptoms, such as pain, shortness of breath, anxiety or nausea. Overall, the goal of palliative care is to create a “goals of care plan” that honors patients’ wishes, making sure they know they have control of their medical future.

“Respecting patient autonomy and concerns as the goals of a care plan are formed allows peaceful understanding for many, even as they face serious or incurable illnesses. Sometimes, just listening, answering questions and honest discussion of a prognosis is helpful,” Dr. Nordstrom says.

Dr. Nordstrom adds there’s still a lack of knowledge and awareness around palliative treatment. He says many health professionals still do not understand it. He says some inaccurately believe palliative care providers only work to talk patients out of health care interventions or take away their hope.

“Palliative care has been shown and validated in numerous studies to improve quality of life for patients and families, relieve symptoms, reduce cost of care and possibly prolong life. There is no study that demonstrates any reduction of lifespan by having a palliative care intervention,” Dr. Nordstrom says.

When to Consider Palliative Medicine

Palliative care is appropriate for patients with various illnesses including COPD, heart failure, Parkinson’s disease, dementia, liver disease, kidney disease or cancer. There is no age limit. Palliative medicine providers see all types of patients, from expectant parents experiencing an abnormal pregnancy to patients over 100 years of age.

“There are many ‘triggers’ that can be used to promote a referral for a palliative care evaluation. The evaluation can be helpful for patients with frequent hospital admissions or clinic visits, complex medical needs, global decline in function, transition to or need for a higher level of care, or a need to help with discussion about advanced directives and advanced care planning,” Dr. Nordstrom says.

The Palliative Care Medical Team

Physicians, nurse practitioners, social workers, nurses, chaplains and other therapists are all part of the palliative care team. With this interdisciplinary team working with the patient and family, they are able to address the physical symptoms, as well as the emotional, spiritual, psychosocial and economic aspects of serious illness. UnityPoint Health has inpatient and outpatient palliative care teams, and some sites have palliative therapy clinics.

Hospice and Palliative Care

Hospice and palliative care are not the same. Hospice care is a service that provides palliative care for terminally ill patients. In other words, all hospice care is palliative care; however, the opposite is not always true.

“Hospice care is a defined insurance benefit for patients who have terminal illness with an expected prognosis of six months or less, if the illness follows the usual course. This generally means hospice patients will not return to the hospital, not receive IV medications, other than symptom relief medicines, and not continue chemotherapy or dialysis. Palliative care is a medical specialty, and no treatment option or aggressive intervention is ruled out, if it is consistent with the patient’s condition and goals of care,” Dr. Nordstrom says.

Why Palliative Care is Important?

“Palliative care is important because it gives patients a voice to participate in their medical care and decision making. It honors them and their autonomy. It helps patients choose and receive care they want and need,” Dr. Nordstrom says.

Palliative medicine can also help patients plan for the future. Dr. Nordstrom compares a serious illness to a long, hard trip, saying no one would reasonably embark on a difficult trip without some advanced planning and preparations. In the same way, palliative medicine helps patients and families plan for their individual illness.

If you’re interested in palliative care, just ask! Consult with your UnityPoint Health primary care provider or specialist and figure out where you should go for information and a consultation.

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