Until recently, palliative care—a type of medical care that focuses on making a person who is seriously ill as comfortable and pain-free as possible—was used only when death was imminent.
Now: Palliative care is being extended to people suffering from any stage of serious illness.
This approach has many benefits. The patient has a better quality of life...families and caregivers get more support...and medical costs are reduced. In fact, a recent study published in Archives of Internal Medicine found that palliative care saved hospitals up to $374 per patient per day in pharmacy, laboratory and intensivecare costs).
To learn more about this new vision of palliative care-and how more people can take advantage of it--we spoke with Diane E. Meier, MD, one of the world's leading experts on this type of medical care and a recent winner of the prestigious MacArthur "Genius" Fellowship.
How does palliative care differ from other types of medical care?
Palliative care, which primarily is offered in hospitals (usually on an inpatient basis, but sometimes to outpatients), focuses on easing suffering by putting an emphasis on relief of a patient's pain and other symptoms, as well as overall improvement in his/her quality of life. For example, it complements ongoing care by helping patients control pain, reduce nausea, improve appetite, relieve fatigue and/or depression and live a meaningful life despite the limitations of illness.
Palliative care can help a Parkinson's disease patient, for example, carry on with daily life by relieving such symptoms as joint pain and shortness of breath.
Are there any other advantages of palliative care?
There are several. For one, most physicians cannot always spend a great deal of time discussing treatment goals and options. A palliative care team, however, is able to give patients as much time as they need to get the information and guidance that is necessary to make the best medical decisions.
With palliative care, patients also get a team of specialists. Depending on an individual's needs, the palliative care team may include doctors, nurses, social workers, psychologists, massage therapists, chaplains and pharmacists as well as nutritionists.
Who is eligible for palliative care?
Doctors can administer palliative care to anyone who has been diagnosed with a serious, life-threatening or progressive illness that causes debilitating symptoms.
Diseases treated with palliative care include cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, kidney or liver failure, Parkinson's disease, dementia and autoimmune disorders, including multiple sclerosis and lupus erythematosus.
Palliative care may be particularly helpful for people with a serious or chronic illness who have been admitted to the hospital three or more times in the past year...if they visit an emergency room once a month or more if their illness stops responding to ongoing treatment ...and/or if basic life functions such as breathing or eating-are affected. But people can take advantage of palliative care at any time-even immediately after diagnosis or during the early stages of disease. Palliative care generally is covered by insurance.
Is palliative care the same as hospice?
Definitely not. If a doctor suggests palliative care, it does not necessarily mean that you are close to dying. It simply means that you could benefit from more extensive care to give you a better quality of life.
How does palliative care help support the patient's family?
Palliative care provides emotional support for family members, helps them navigate the health-care system and provides guidance to assist them and their loved ones in making difficult treatment choices.
What's the best way to seek out palliative care?
The first step is to approach your doctor Sadly, most practicing physicians were not trained in palliative care, and your doctor may not know much about it. If you feel you need help describing palliative care, give your doctor a copy of this article.
Take this opportunity to clarify your understanding of your diagnosis, disease progression or treatment. And tell your doctor whether—and how much your disease is limiting your life due to pain, depression or other factors.
What if the hospital my doctor is affiliated with doesn't offer palliative care?
At some point, all hospitals will offer palliative care. However, if your doctor is not affiliated with a hospital that provides this type of care, you may have to be proactive and seek out a hospital that does.
You can check the Web site of the Center to Advance Palliative Care, www getpalliativecare.org, to see which hospitals in your area offer palliative care. Click on "Provider Directory," and search your hometown as well as surrounding cities.
About 1,300 US hospitals now offer palliative care. Once you find a nearby hospital on the list, ask your doctor for a referral to the hospital's palliative care team.
