Palliative Care (PC) is a relatively new specialty area in healthcare delivery. Nursing, medicine, and several other disciplines are offering palliative care-specific education to enhance healthcare provider knowledge. PC is focused on helping patients diagnosed with chronic (not curable), life-threatening, and/or serious injuries/illnesses (potentially curable). Therefore, the primary goal of palliative care is to enhance the quality of life for the patient and their family, by anticipating, preventing, and treating symptoms and suffering from illness. PC is not limited to one specific population but rather serves all age groups, including neonates, children, adolescents, young adults, and older adults, across all healthcare settings. To attain this goal an interdisciplinary PC team of doctors, nurses, allied healthcare providers, and others focus on the patient’s and family’s/caregiver’s needs, not just on the illness or injury. This interdisciplinary approach requires a new emphasis on provider-patient and provider-provider communication by coordinating care and addressing not just traditional therapies, but also spiritual, psychological, and emotional support for the patient and her/his family or caregivers.
FAQs & Resources
Frequently Asked Questions
As discussed above, Palliative Care is a broad specialty area that includes patient care from diagnosis with a chronic or serious disease or injury to death. Therefore, hospice is one aspect of Palliative Care. They are both governed by the same values, beliefs, and goals—to provide the best quality of life for the patient, but in addition, for hospice patients—the best quality of death. However, it should be understood that eligibility for hospice care from an insurance (Medicare, etc.) perspective requires patients to be diagnosed by two separate physicians with a terminal disease and have a prognosis of six months or less to live. Adult patients who are in a hospice care setting can leave, by their own accord at any time. In addition, if patients want to stop hospice care and return to chemotherapy, or have surgery—they can do so whenever they choose.
For children, palliative care can be offered concurrently with hospice care. For example, children with cancer can continue to receive chemotherapy while receiving the hospice benefit.
No, as discussed in #2, Palliative Care is not disease/injury-focused. Instead, PC is patient/family/caregiver-centered and whether a patient is newly diagnosed with diabetes, cancer, or other chronic illness, or has a serious brain or spinal cord injury—Palliative Care is intended to help that patient and his/her family/caregivers attain the best quality of life possible. The focus is on the patient and his/her wishes, needs, and/or desires. This is the same approach for children, adults, and the elderly. One approach that is patient-centered, not disease, injury, or provider-focused.
Read About the Diverse Benefits of a Palliative Care Approach
Palliative Care is appropriate for a wide array of chronic diseases, serious injuries, and terminal prognoses. Specifically, some of these illnesses/injuries (from their first diagnosis to a terminal prognosis) include:
- Alzheimer’s Disease/Dementia
- Traumatic Brain Injuries
- Cerebrovascular Accidents (CVA)/Strokes
- Cancers
- Chronic Obstructive Pulmonary Disease (COPD)/Emphysema
- Congenital Syndromes/Anomalies
- Congestive Heart Failure (CHF)
- Coronary Artery Disease/Angina
- Cystic Fibrosis
- Diabetes (Type 1 and Type 2)
- Genetic Conditions
- Hematologic Disorders
- Hypertension (high blood pressure)
- Immunodeficiency Disorders
- Neurologic/Neuromuscular Disease/Amyotrophic Lateralizing Sclerosis (ALS)/Lou
- Gehrig’s Disease/Parkinson’s Disease/Multiple Sclerosis/Muscular Dystrophy
- Spinal Cord Injuries/Paraplegia or Quadriplegia
Regardless of the disease or injury that creates the need for a palliative approach—the goal is always the same—patient-centered, quality-of-life-focused care. While most of the diseases and injuries listed in #4 are incurable, they all can be treated in ways that minimize a patient’s pain and discomfort while maximizing her/his abilities to attain realistic self-determined health/life goals (walking, playing with siblings/peers/children/grandchildren, traveling, and so forth). The benefits for the patient, as well as her/his family/caregivers from a Palliative Care perspective, are more control and empowerment in health care decision-making, effective pain and symptom management, and an interdisciplinary team approach to improving the patient’s and the family’s/caregiver’s quality of life—physically, emotionally, and spiritually.
The Palliative Care Interdisciplinary Team (IDT) is a unique approach to patient-centered, quality-of-life-focused healthcare delivery. Instead of the traditional, hierarchical, physician-leader method that is generally the norm, an IDT uses a broad array of providers and caregivers to help ensure that a patient’s physical, emotional, and spiritual health—not just his/her disease, is everyone’s foci. An IDT is generally comprised of many of the following Palliative Care providers:
- Nurses (RNs & Advanced Practice Registered Nurses (APRNs)
- Doctors
- Physician Assistants
- Physical and/or Occupational Therapists
- Social Workers
- Pharmacists
- Chaplains
- Music &/or Art Therapists (if on staff)
- Child Life Specialists (pediatric PC)
The goal of the IDT is to find the most effective ways to provide the patient, family, and/or caregivers with the quality of life and care the patient desires. By utilizing an interdependent, interdisciplinary team approach the staff seeks to find a collaborative and participative method(s) for attaining the patient’s health and quality of life goals.
Kanarek Center for Palliative Care Videos
Have You Read...
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"Letting Go"
From The New Yorker
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"For Carl Reiner And His Fellow Nonagenarians, Death Can Wait"
From The New York Times
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"Advance Care Planning: The Nurse’s Role"
By Shigeko Izumi, PhD, RN
On Children and Death
By Elisabeth Kubler-Ross, MD
How We Die: Reflections on Life's Final Chapter
By Sherwin B. Nuland, MD
Man's Search for Meaning
By Viktor Frankel, MD
The Last Lecture
By Jeffrey Zaslow and Randy Pausch, MD
Tuesdays With Morrie
Mitch Albom
In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope
By Rana Awdish, MD
Walking Each Other Home
by Ram Dass and Mirabai Bush
The Untethered Soul
by Michael Singer
Peace
by Mahatma Gandhi
Sum: Forty Tales from the Afterlives (fiction)
by David Eagleman
From Sun to Sun: A Hospice Nurse Reflects on the Art of Dying
by Nina Angela-McKissock, RN
Death is But a Dream
by Christopher Kerr, MD
Letting Go
by Morrie Schwartz
Living Well with a Serious Illness: A Guide to Palliative Care for Mind, Body, and Spirit
By Robin Kanarek
When Breath Becomes Air
By Paul Kalanithi, MD
That Good Night: Life and Medicine in the Eleventh Hour
By Sunita Puri, MD
Being Mortal: Medicine and What Matters in the End
By Atul Gawande, MD
The Art of Dying Well: A practical Guide to a Good End of life
by Katy Butler
My Father’s Wake: How the Irish Teach Us to Live, Love, and Die
by Kevin Toolis
Healing After Loss: Daily Meditations for Working Through Grief
By Martha Whitmore Hickman
When Death Becomes Life
by Joshua D. Mezrich, MD
The End of Your Life Book Club
by Will Schwalbe
Tuck Everlasting
by Natalie Babbitt (fiction)
Death: The Final Stage of Growth
by Elizabeth Kubler-Ross
In Lieu of Flowers: A Conversation for the Living
by Nancy Cobb
One Night Two Souls Went Walking
by Ellen Cooney