Palliative Care: What is it and When to Consider it

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. Amy Callaghan, DO, 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 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. Callaghan says.

She adds there’s still a lack of knowledge and awareness around palliative treatment, and many still don't understand it. Some people may inaccurately believe palliative care providers only work to talk patients out of healthcare 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's no study that demonstrates any reduction of lifespan by having a palliative care intervention.” 

When is Palliative Care Needed?

Palliative care is appropriate for patients with various illnesses including COPD, heart failure, Parkinson’s disease, dementia, liver disease, kidney disease or cancer. There's no age limit. Palliative medicine providers see all types of patients, from an expectant parent experiencing an abnormal pregnancy to patients more than 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 discussions about advanced directives and advanced care planning,” Dr. Callaghan says.

Who's on a Palliative Care 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're 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.


Palliative Care vs Hospice 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 a 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, 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's consistent with the patient’s condition and goals of care,” Dr. Callaghan says.

Why Palliative Care is Important

“Palliative care is important because it gives patients a voice 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. Callaghan says.

Palliative medicine can also help patients plan for the future. Dr. Callaghan 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, consult with your UnityPoint Health primary care provider or specialist for more information.

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