Palliative vs. hospice care
It’s a tough situation when a loved one faces an illness that requires care beyond what can be provided at home.
And palliative care is an option that can help patients who have physical, emotional, spiritual or social needs that arise while receiving treatment for a serious or chronic illness. It complements curative, life-prolonging treatment, and is often provided in a hospital setting.
Different from hospice, palliative care is appropriate for patients of all ages and in all disease stages. While palliative care has long been associated with or even confused with hospice care, which is comfort care given at the very end of life, palliative care can help patients who suffer serious medical conditions, but are still benefitting from treatment.
A palliative care team can include social workers, chaplains, physical, occupational and speech therapists, and physician specialists such as neurologists, cardiologists and pulmonologists. The team assesses and treats symptoms, assists with identifying family and patient goals, and mobilizes community resources on behalf of the patient.
Nearly 90 percent of large U.S. hospitals, at least 300, already have palliative care consultation services, according to the Center of Advanced Palliative Care. Inpatient palliative care units focus on treating severe pain, difficulty breathing, nausea, fatigue and other symptoms that cause unnecessary discomfort for patients. Services are provided by a team of specially-trained doctors, nurses and social workers, all of whom consult with the primary physician.
Hospitals with designated palliative care units usually offer private patient rooms, accommodations for family members who want to stay overnight and meeting rooms for families and for consultations. Some patients in palliative care can get more aggressive therapy. Once the patient’s condition is stabilized, he or she can be discharged to home or to a nursing home.
Who benefits from palliative care?
A variety of patient situations can be helped by palliative care services, such as patients who need treatment for infection or management of pain with high doses of pain medication and careful monitoring with dose adjustment. Another example is a patient who has been on a ventilator but needs observation after discontinuation.
Evidence of patients with metastic, non-small cell cancer suggests that early involvement of palliative care produces a longer survival, improved quality of life, and less depression than what is seen in patients receiving standard care alone. The ultimate goal is to make the patient more comfortable.
Originally, palliative care focused primarily on elderly patients who were diagnosed with a terminal cancer. However, it now serves patients dealing with cardiac, renal, neurological and respiratory illness. A patient with terminal disease deserves compassionate guidance and care so they may embrace their treatment from physical, emotional and spiritual perspectives.
This article is co-authored by Dr. Pramern Srirantana, Mid-Illinois Hematology & Oncology Associates and Theresa Bailey, RN, BSN, palliative care coordinator, at Advocate BroMenn Medical Center in Bloomington, Ill.
About the Author
Dr. Pramern Sriratana is Board Certified in Internal Medicine, Hematology, and Medical Oncology and has been in practice at Mid-Illinois Hematology & Oncology Associates, Ltd. since its inception in 1979. His areas of interest include lung, breast, gastrointestinal, genitourinary, and central nervous system cancers, as well as hematology and hematologic malignancies. Teresa Bailey, RN, BSN, serves as coordinator of the Palliative Care program at Advocate BroMenn Medical Center.