Palliative Care
This topic will help you understand what palliative care is and how to prepare for it.
What is palliative care?
Palliative care is a comprehensive medical approach aimed at improving the quality of life for patients living with serious or life-threatening illnesses, such as cancer, heart disease, or progressive neurological disorders. This type of care focuses on relieving pain and other distressing physical symptoms while also addressing the psychological, social, and spiritual aspects that may accompany the illness journey. It is provided alongside other treatments that aim to control or slow the progression of the disease, and it is not limited to end-of-life stages, as some may mistakenly believe.
Palliative care can begin as early as the time of diagnosis and continue throughout treatment, even into the final stages if needed. It focuses on managing symptoms such as pain, fatigue, nausea, loss of appetite, and insomnia, while also providing psychological, spiritual, and practical support for the patient and family.
The World Health Organization explains that palliative care is a fundamental human right and an integral part of universal health coverage. It works to prevent and relieve suffering through early identification, accurate assessment, and treatment of symptoms, while offering comprehensive support for patients and their families through a multidisciplinary team.
When should you consider palliative care? Who can benefit?
Palliative care is appropriate when a patient has a chronic or life-threatening condition that causes physical, emotional, social, or spiritual distress, regardless of whether the disease can be cured. It applies to many conditions, including various stages of cancer, progressive neurological disorders, dementia and Alzheimer’s, chronic heart disease, kidney or liver failure, cystic fibrosis, advanced lung diseases, chronic infections like HIV/AIDS, and certain bone marrow or blood disorders that require stem cell transplants.
The World Health Organization reports that about 56.8 million people worldwide require palliative care each year, including 25.7 million people in their last year of life. However, less than 14% actually receive the care they need, highlighting the importance of national policies and plans that ensure palliative care is integrated into health services for all, especially older adults and patients with non-communicable diseases.
Providing palliative care early, alongside other treatments like chemotherapy or radiotherapy, can help reduce symptoms, improve quality of life, and may even have a positive impact on the course of the illness.
How to prepare for palliative care?
Preparing for palliative care is a crucial step that enables patients and their families to achieve the best possible comfort and quality of life while facing illness. It starts with an open conversation with the treating physician to understand the medical condition, expected symptoms, and available care options. It is helpful for the patient to write down their priorities and goals, such as the wish to stay at home as much as possible or to have optimal pain control.
It is also recommended to discuss financial and legal matters early, if necessary, including medical power of attorney and advance care directives. Family members or caregivers should be involved in this planning so everyone is aware of the next steps. Ultimately, the palliative care team can offer guidance on care arrangements, whether in a hospital, at home, or in specialized palliative care facilities.
How is palliative care delivered?
1) Medical and nursing care: The palliative care team provides continuous monitoring of the patient’s health through specialized doctors and nurses. They manage the necessary medications to control symptoms such as pain, shortness of breath, or nausea, and they monitor any medical complications depending on the condition. For example, strong painkillers (such as morphine) may be used, or relaxation sessions and breathing exercises may be recommended to help ease symptoms.
2) Psychological and social support: The palliative care team includes psychological and social care specialists who support the patient and family members in coping with anxiety, stress, or potential depression. Individual or family counseling sessions may be offered, or the patient may be referred to community support groups for additional assistance. This helps reduce emotional burdens and improve communication within the family.
3) Functional support and rehabilitation: Depending on the patient’s needs, the team may include a physical or occupational therapist who teaches the patient techniques to maintain independence as much as possible, such as simple exercises to improve mobility or using assistive devices at home.
4) Nutritional and pharmaceutical support: A clinical nutritionist and pharmacist help create an appropriate nutrition plan to maintain weight and physical strength while reviewing medications to avoid interactions and ensure effectiveness.
5) Spiritual or religious support: When requested, the palliative care team can provide spiritual support through chaplains or spiritual advisors, allowing the patient to find comfort and strength through faith during this stage.
Frequently asked questions about palliative care:
Does palliative care mean the patient is at the end of life? No. Palliative care can start at any stage of the illness, from diagnosis to the final stages. The goal is to enhance comfort, alleviate symptoms, and provide psychological, social, and spiritual support to the patient and their family.
Where can palliative care be provided? Palliative care can be provided in hospitals, outpatient clinics, specialized palliative care units, through home visits, and even via virtual clinics. It is supervised by a multidisciplinary team that includes doctors, nurses, social workers, psychologists, and spiritual advisors according to the patient’s needs.
What is the real benefit of palliative care? Palliative care helps reduce unnecessary hospital stays, improves the quality of life for patients and caregivers, and alleviates distressing symptoms such as pain, anxiety, and shortness of breath. It also increases patient and family satisfaction with the overall healthcare experience.
Can a patient receive palliative care while still having curative treatment? Yes, palliative care can be provided alongside treatments aimed at curing the disease or slowing its progression, such as chemotherapy, radiation therapy, or new medications. The goal is to improve the patient’s quality of life and reduce the side effects of the primary treatment.
Does palliative care include support for the patient’s family? Absolutely. Palliative care supports families and caregivers by providing psychological and social counseling, helping them cope with additional responsibilities. It also offers bereavement counseling and emotional support if the patient passes away.
Are there specific medications used in palliative care? Palliative care includes medications for relieving acute and chronic pain, such as morphine and its derivatives, to ease severe symptoms. Other drugs may be used to manage nausea, shortness of breath, or insomnia. These medications should always be used safely under medical supervision to balance pain relief and avoid complications.
