Authored by Cathy L. Chambers in Health Care
Published on 10-08-2009
Palliative care is a branch of medicine that focuses on relieving the pain and stress of serious illness. Palliative care differs from hospice care, which is provided to terminally ill patients who are no longer seeking a cure. Hospice care includes palliative care but focuses on providing comfort and relief for those who no longer seek a cure. Palliative care may be started at any stage of illness and is often provided along with curative measures.
Palliative care embraces a team approach to medicine. Chaplains, nursing staff and social workers work together to provide for the physical, emotional and spiritual care of the patient. These professionals work along with the primary care physician to assist the patient. Palliative care teams in hospitals also work with families to assist them in navigating the medical system. The team can help the patient and their family by providing clear, open communication between medical staff and the patient. Other services provided by the team can include treatment of pain and other symptoms, guidance in making difficult medical decisions and spiritual support.
Palliative care is not a singular approach to medicine. Palliative care teams provide a wide variety of treatment options for a wide variety of illnesses. The major benefit to working with a palliative care team is that each patient receives care that is designed to meet their needs. Close communication between the patient, their family and the team ensures that each patient sets their own goals for treatment. The result is improved quality of life for the patient. Patients who receive palliative care are better able to cope with daily life. They have a better understanding of their illness and the treatments available to them. Receiving palliative care improves the ability of the patient to tolerate medical procedures.
The key to palliative medicine is the ability to provide patients a way to deal with their distress or their total suffering. Palliative care teams have become very effective in helping patients manage pain with drugs like morphine safely while maintaining full functions and facilities. Along with their physical symptoms, patients often suffer from psychological, social or spiritual symptoms. Social workers or counselors and chaplains are beneficial in assisting not only the patient but their families as well. Dealing with all aspects of the illness can help both the patient and their family deal with illness on all levels rather than relying only on medical and pharmaceutical interventions.
In the United States, hospice and palliative care have different locations and payment systems. Hospice care is part of Medicare coverage. As a condition of Medicare coverage, two doctors must certify that a patient has six month or less to live. Most hospice care is provided in a patient’s home or in a long term facility. Palliative care on the other hand is not restricted to certain diseases or prognosis. Palliative care can be offered in an acute care hospital by a team in an acute palliative care ward. Unlike hospice care, which is covered by Medicaid, Medicare and most major insurance providers, palliative care in the United States is provided through philanthropic services or from direct hospital services. Programs require large teams and extensive amounts of time. Most patients do not have adequate savings or insurance to cover the cost. Funding palliative care programs generally focus more on cutting costs than generating revenue for the hospital.
While the service provided by palliative care teams may seem far-reaching, the goals are concrete. To provide comfort and relief from pain other distressing symptoms, to provide support to allow the patient to live as actively as possible and to provide a support system for the family.