Palliative care has experienced a rebirth: it is now a life-focused approach to cancer care that’s changing both how doctors and patients deal with the disease. Historically, palliative care was associated with relieving pain and discomfort for the dying. Today, palliative care is considered an integral part of cancer care, mainly because people are living longer, more productive lives with cancer as a chronic illness.
Palliative comes from the word “palliate,” which means to make comfortable by treating and relieving the symptoms of an illness. For both cancer patients and families, palliative care is often a key to maintaining the highest possible quality of life.
When you are facing a serious illness like oral cancer, you need relief. Relief from pain. Relief from other symptoms, such as fatigue, nausea, loss of appetite and shortness of breath. Relief from stress. You need to better understand your condition and choices for care. You need to improve your ability to tolerate medical treatments. And, you and your family need to be able to carry on everyday life.
In short, you want to feel better, feel supported and have more control over your care. This is what palliative care can do for you. It is important that you understand that palliative care is an individual choice for each patient depending on your specific goals. There is no one answer for everyone. The goal of palliative care is to relieve suffering a provide the best possible quality of life for people facing the pain, symptoms and stresses of serious illness.
Palliative Care Facts
- Some patients receive palliative care and continue to pursue other life-prolonging programs, including chemotherapy, radiation and surgery.
General physicians are typically key members of the palliative care team and can coordinate services and participate in care. Palliative care is offered in a wide range of locations, including doctors’ offices, clinics, long-term care settings and at home. Many medical institutions have begun to develop palliative care programs on site to augment their existing services. Medical organizations and professionals recognize palliative care as not only one of the newest disciplines in the health care field, but as a medical specialty. Professionals who specialize in palliative medicine receive special training and certification.
- Several organizations, such as the American Academy of Hospice and Palliative Medicine, provide referrals to physicians who specialize in palliative care.
How it works?
When the Palliative Care Consult Service is asked to see a hospitalized patient, the patient’s medical records are thoroughly reviewed to ensure a good understanding of the patient’s medical condition and prognosis. After this review the palliative care physician and nurse meet with the patient and family to identify care needs. The palliative care team then makes recommendations to the primary physicians and provides ongoing consultation while the patient is in the hospital. The Palliative Care Consult Service often assists with dismissal planning, which may include referral to hospice care, skilled nursing care or home health care.
Palliative care can begin as soon as curative treatment is no longer an option no matter how much longer the person is expected to live. A palliative care specialist should be able to anticipate the patient’s needs as the disease and progresses with their knowledge of the usual outcomes for the various types of cancer and put the proper supports in place. They should be easy for you to reach when needed. You need to make your medical team aware of any and all symptoms so that they can be dealt with.
How to get palliative care?
The first step is to talk to your own doctor. Most of the time, you have to ask your doctor for a palliative care referral to get palliative care services. Whether you are in the hospital or at home, a palliative care team can help you. Following are some tips to help you talk to your doctor:
- Tell your doctor you are considering palliative care and ask what palliative services are available in your area.
- Ask your doctor to explain your illness as well as past, current and future treatments and procedures.
- Explain to your doctor what quality of life means to you. This list may include being able to spend time with loved ones, having pain and other distressing symptoms aggressively treated, the ability to make your own decisions for care and your preferred location of treatments (home vs. hospital).
- Be sure your doctor is aware of any personal, religious, or cultural beliefs, values or practices that are important to consider in your care and treatment decisions.
- Tell your doctor what curative treatments you may or may not want, such as resuscitation if your heart were to stop, being placed on a mechanical ventilator if your lungs were to fail, undergoing dialysis if your kidneys were to fail, and artificial nutrition by a feeding tube if you were unable to eat.
- If you have completed a living will or health care proxy, be sure to inform your doctor and provide him or her with a copy.
- If you are suffering with pain and other symptoms due to a serious illness, ask your doctor for a palliative care referral.
Where do patients receive palliative care?
Cancer centers and hospitals often have palliative care specialists on staff. They may also have a palliative care team that monitors and attends to patient and family needs. Cancer centers may also have programs or clinics that address specific palliative care issues, such as lymphedema, pain management, sexual functioning or psychosocial issues. A patient may also receive palliative care at home, either under a physician’s care or through hospice or at a facility that offers long-term care.
Who pays for palliative care?
Palliative care services are usually covered by health insurance. Medicare and Medicaid also pay for palliative care, depending on the situation. If patients do not have health insurance or are unsure about their coverage, they should check with a social worker on their hospital’s financial counselor.
If a person accepts palliative care, does it mean he or she won’t get cancer treatment?
No. Palliative care is given in addition to cancer treatment. However, when a patient reaches a point at which treatment to destroy the cancer is no longer warranted, palliative care becomes the total focus of care. It will continue to be given to alleviate the symptoms and emotional issues of cancer. Palliative care providers can help ease the transition to end-of-life care.
Can a family receive palliative care?
Yes. Family members are an important part of cancer care, and, like the patient, they have a number of changing needs. It’s common for family members to become overwhelmed by the extra responsibilities placed upon them. Many find it difficult to care for a relative who is ill while trying to handle other obligations, such as work and caring for other family members. Other issues can add to the stress, including uncertainty about how to help their loved one with medical situations, inadequate social support and emotions such as worry and fear. These challenges can compromise their own health. Palliative care can help families and friends cope with these issues and give them the support they need.
How do people talk about palliative care or decide what they need?
Patients and their loved ones should ask their doctor about palliative care. In addition to discussing their needs for symptom relief and emotional support, patients and their families should consider the amount of communication they need. What people want to know about his or her diagnosis and care varies with each person. It’s important for patients to tell their doctor about what they want to know, how much information they want and when they want to receive it.