Palliative care is a growing field of medicine. Still, there’s some confusion about what palliative care is, what it entails, who should get it, and why.
The goal of palliative care is to improve the quality of life for people with serious or life altering illnesses. It’s sometimes called supportive care.
Palliative care is about improving overall wellness, including physical, emotional, spiritual, and social well-being.
Palliative care is focused on improving the overall wellness of individuals with serious illnesses. It addresses both the symptoms and the stress of living with a chronic illness. It may also involve support for loved ones or caregivers.
Since it’s based on individual needs, palliative care can be quite different from one person to the next. A care plan might involve one or more of the following goals:
- alleviating symptoms, including side effects of treatment
- improving understanding of illness and its progression
- identifying and addressing practical and spiritual needs
- helping to cope with feelings and changes related to illness
- assisting in understanding treatment options, making treatment decisions, and coordinating care
- identifying and accessing additional resources to provide support
Palliative care can be an option for many conditions. Cancer, dementia, and chronic obstructive pulmonary disease (COPD) are some of the most common conditions where palliative care can be especially helpful. These examples are explained in more detail below.
Palliative care for cancer
Cancer is one of the most common illnesses associated with palliative care, as both symptoms and treatment can have a significant impact on your quality of life.
Palliative cancer care varies depending on the type of cancer, as well as symptoms, treatment, age, and prognosis.
Someone with a recent cancer diagnosis might receive palliative care to manage the side effects of chemotherapy or radiation, or to help them recover after surgery.
Palliative care for cancer often includes treatments for depression or anxiety, and tools to help family members plan for the future.
Palliative care for dementia
Dementia is associated with deteriorating brain function. It greatly impacts a person’s cognition, memory, language, judgment, and behavior.
Palliative care might include treatment for anxiety caused by dementia. As the illness progresses, it might involve helping family members make difficult decisions about feeding or caring for their loved one. It can also involve support for family caregivers.
Palliative care for COPD
Palliative care can help manage COPD, a respiratory illness that causes coughing and shortness of breath.
For this condition, palliative care might include treatments for discomfort, anxiety, or insomnia associated with difficulty breathing. You might receive education on lifestyle changes, such as quitting smoking, that can improve your activity level and slow the progress of your illness.
The main difference between palliative and hospice care is when each type of care is offered.
For people with a serious and potentially life threatening condition, palliative care is available at any time, regardless of the stage of the illness. It doesn’t depend on your prognosis or life expectancy.
In contrast, hospice care is only available at the end of life, when an illness is no longer responding to treatment. At this time, the individual may decide to stop treatment and begin hospice care, also known as end-of-life care.
Like palliative care, hospice is focused on a person’s overall comfort, including their emotional, physical, and spiritual well-being. In fact, hospice is considered a form of palliative care. However, receiving palliative care doesn’t necessarily mean you’re in hospice.
To qualify for hospice care, a doctor has to estimate that your life expectancy is 6 months or less. This can be incredibly difficult to determine.
Hospice care doesn’t always signal the end of life. It’s possible to receive hospice care and then resume curative or life-prolonging treatments.
Palliative care is provided by a multi-disciplinary team of healthcare practitioners with specialized training in this type of medicine.
Your palliative care team could include any of the following:
- a palliative care doctor
- other doctors, such as a respiratory specialist, neurologist, or psychiatrist
- a social worker
- a counselor
- a psychologist
- a prosthetist
- a pharmacist
- a physical therapist
- an occupational therapist
- an art or music therapist
- a dietitian or nutritionist
- a chaplain, pastor, or priest
- palliative care volunteers
Your palliative care team will work to ensure your holistic well-being over the course of your illness.
If you have a serious or life threatening illness, you can ask about palliative care at any time.
There’s a common misconception that you have to wait until your illness is in a later stage or terminal to get palliative care. In fact, a number of studies suggest that palliative care is most effective when started early.
A 2018 review of people with advanced non-small cell lung cancer (NSCLC) recommended early adoption of palliative care, which improves both quality of life and overall survival.
Palliative care has also been shown to reduce depression and other mental illnesses. The authors of a 2018 study concluded that people with advanced cancer who also had symptoms of depression stood to benefit the most from starting palliative care early.
Your loved ones are also likely to benefit from your palliative care, which can help them access resources and support to cope with your illness.
It depends on where you live. Palliative care has become more accessible in recent years, but it’s still not available everywhere.
Depending on where you live, you might have more than one option as to where you receive palliative care. Some options may include:
- a hospital
- a nursing home
- an assisted-living facility
- an outpatient clinic
- your home
Talk to your doctor to find out more about the palliative care options that are available to you and where you can receive care in your area.
The first step in receiving palliative care is to ask your doctor or healthcare provider about it. Your doctor should refer you to a palliative care specialist.
You can prepare for your palliative care consultation by making a list of your symptoms and how they impact your everyday activities. You’ll also want to bring a list of medications you take and any relevant medical history.
It’s a good idea to ask a friend or family member to accompany you to your appointment.
After your consultation, you’ll work with your palliative care team to develop a plan. The plan will be based on your symptoms and any treatments you’re currently undergoing, as well as how your illness is affecting your mental health, everyday activities, and family members.
The plan will be carried out in coordination with any other treatments you’re receiving. It should evolve over time as your needs change. It may eventually involve advanced care and end-of-life planning.
It’s important to talk to your palliative care provider to understand what you may be required to pay for.
Both Medicare and Medicaid may cover some palliative services. However, since neither Medicare nor Medicaid use the term “palliative,” the treatment you’re receiving has to be covered by your standard benefits.
Both Medicare and Medicaid cover all hospice-related charges, but to qualify for hospice a doctor must determine that you have 6 months or less to live.
If you have private insurance, you might have some coverage for palliative services. A long-term care policy is another option to cover palliative services. Check with a representative from your insurer to confirm coverage.
Palliative care is a multi-disciplinary treatment aimed at improving the quality of life and overall well-being of individuals with chronic, life altering illnesses. It may also involve support for loved ones or caregivers.
If you or someone in your family has a serious illness, palliative care may be an option you want to consider. Talk to your doctor to find out more about palliative care and what you need to do to get this type of care.