Palliative care is a growing field of medicine. Still, there’s some confusion about what palliative care is, what it involves, who should get it, and why.

The goal of palliative care is to improve the quality of life of 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 people 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. Some of the most common conditions where palliative care can be especially helpful are:

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
  • symptoms
  • treatment
  • age
  • 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 cardiovascular diseases

Cardiovascular diseases can affect a person’s quality of life and their ability to care for themselves. Cardiovascular diseases include:

Palliative care may be underutilized globally for people with cardiovascular diseases, according to the World Health Organization (WHO).

In a 2019 review, researchers studied trends in places of death for people with cardiovascular diseases in the United States. The review notes that early palliative care may help increase the likelihood that people with these diseases will experience their desired end-of-life outcomes. Increasing early palliative care may also increase referrals to hospice care.

Palliative care for cardiovascular disease may help symptom relief, mental health support, and decision making for people with these diseases and their families. It may also include help with end-of-life planning, should that be needed.

Palliative care for dementia

Dementia is associated with deteriorating brain function. It greatly impacts a person’s:

  • cognition
  • memory
  • language
  • judgment
  • 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 people 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.

Palliative care for diabetes

Diabetes is a chronic condition that affects how the body turns food into energy. About 25% of people over 65 years old have diabetes while 50% of older adults have prediabetes. Older age is also associated with other chronic medical conditions.
According to a position statement from the American Diabetes Association, one-third of people with diabetes enrolled in palliative care are enrolled within the last 2 weeks of life, which can prevent them from having full access to the benefit of palliative care services. Their 2021 recommendation includes making adjustments to care for older adults with diabetes to increase comfort.
For older adults with this condition, palliative care may include relaxing therapies, simplifying medication, mental health support, and providing education to both the person with diabetes and their family and caregivers.

The goal of palliative care is to improve the quality of life in people experiencing serious or terminal illness and to support their families. Some of the benefits can include:

  • Symptom management support. Palliative care specialists may help people with symptom management and pain management, according to a 2017 review on people living with advanced cancer.
  • Improved quality of life. According to a 2020 study of people with Parkinson’s disease and related disorders, those who received palliative care scored their quality of life as three points higher than those with traditional treatment.
  • Reduced risk of depression. Early palliative care is associated with a lower risk of depression in people newly diagnosed with advanced cancer, according to a 2017 review of research.
  • Longer survival. The same review suggests that depression and mortality may be linked, which may mean longer survival in people with advanced cancer who receive palliative care.
  • Support in making decisions. Palliative care specialists provide support to people diagnosed with a serious illness and their families in order to make decisions about care, treatment for their illness, and support in emotionally coping with the diagnosis.
  • Support for family members and caregivers. Palliative care can include instructional guidance and emotional support for family members caring for a loved one with a serious illness.
  • Improved caregiver satisfaction. According to a 2016 review, palliative care consistently improves both patient and caregiver satisfaction.

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 appropriate at any time, regardless of the stage of the illness. It doesn‘t depend on your prognosis or life expectancy.

You can also access treatment aimed at curing your condition while taking advantage of palliative care treatment designed to improve your quality of life and level of comfort.

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 person 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. You may also qualify for hospice care and go on to live longer than 6 months. You may continue to receive hospice care as long as your doctor believes that you have 6 months or less to live.

Hospice care doesn‘t always signal the end of life. It’s also possible to receive hospice care and then resume curative or life-prolonging treatments.

Summary

  • Palliative care is available at any time, regardless of the stage of the illness or life expectancy.
  • Hospice care is only available at the end of life.

Palliative care is provided by a multidisciplinary team of healthcare professionals 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
  • nurses
  • 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
  • caregiver(s)

Your palliative care team will work to ensure your holistic (all-around) 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, closer to diagnosis.

A 2018 review of people with advanced non-small cell lung cancer (NSCLC) recommended early use of palliative care, which improves both quality of life and overall survival.

Similarly, a 2018 meta-analysis found that people with advanced cancer lived longer and enjoyed a better quality of life when they received outpatient palliative care.

Palliative care has also been shown to reduce depression and other mental health conditions. The authors of a 2017 study found that people with advanced cancer who also had symptoms of depression benefitted the most from starting palliative care early.

Your loved ones are also likely to benefit if you receive 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 can receive palliative care. Some options may include:

  • a hospital
  • a nursing home
  • an assisted living facility
  • an outpatient clinic
  • your home

Talk with 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.

You can also visit the Center to Advance Palliative Care’s Provider Directory to search for a provider near you.

The first step in receiving palliative care is to ask a doctor or healthcare professional about it. The doctor who treats your illness should refer you to a palliative care provider.

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 the 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. If it becomes needed, your plan can also involve advanced care and end-of-life planning.

It’s important to talk with 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 multidisciplinary treatment aimed at improving the quality of life and overall well-being of people 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 with a doctor to find out more about palliative care and how to get this type of care.