Palliative care has been garnering attention in the medical community more so in the last few years than ever before. It has been widely misunderstood. As a result it has been largely passed over as a vital component of comprehensive care. Palliative care also has been considered by some to be outside the scope of a physician’s role. Yet research is proving that more and more physicians want to learn more about it so they can provide it to their patients or work with a palliative care team to optimize the quality of both care and life for their aging patients.
What is palliative care?
Palliative Care Defined
Palliative care is simply the treatment and relief of mental and physical pain without curing the causes, especially in patients suffering from a terminal illness. Palliative care is also a means to ease conditions associated with aging, for while aging is not an illness, it is terminal and physically challenging.
Palliative care can include hospice care, but the scope of palliative care is much larger than easing the pain of passing away. Hospice care is a tool to use when providing palliative care for a patient who is dying.
Palliative care takes whatever form necessary to ease the burden of suffering when a condition is just not responsive to curative treatment. Aging is just such a condition; it cannot be cured, as it is a natural process. Yet aging also presents certain conditions and diseases that can be managed even as they cannot be fully cured, such as heart disease and dementia. Palliative care strives to improve quality of life under the circumstances that may present themselves as a person ages.
The Role of Palliative Care
According to the World Health Organization, palliative care aims to:
- Integrate the spiritual and psychological needs of a person into their treatment approach
- Affirm death as a normal process
- Provide adequate pain relief
- Develop a support system for the entire family that would include counseling for such needs as bereavement as well as any other concerns
- Enhance quality of life by providing a support system to help patients live as actively as possible
Palliative care enables a physician to treat the entire person rather than just the condition they are being seen for. This can be seen in the care of cardiovascular diseases and cancers. There is only so much a doctor can do to treat these conditions that take such a heavy toll emotionally and mentally on patients and their families. Broadening the scope of care to include how a person and caregivers are coping on the whole improves the process and puts more resources within reach.
Some resources that are thought of as being within the scope of palliative care include:
- Pain management
- Help with sleeping
- Mental health treatments
- Physical therapy
- Individual counseling for spiritual concerns
- Establishing advance directives
- Hospice care
- Complementary medicine such as massage, guided imagery, biofeedback, meditation, and other holistic approaches to treatment
The Need for Palliative Care Awareness
With so much to offer, why is palliative care not being implemented by all physicians and specialists? According to the American College of Cardiology, the need for it is largely under-represented. The College recently published the results of a survey conducted by the Geriatric Section Palliative Care Work Group to see if cardiologists were even aware of palliative care and how they came about acquiring knowledge of it. Of the 323 cardiologists who participated, 87% admitted to having some knowledge about it, but just 12% defined that knowledge as extensive. Self-directed learning informed 44% of the doctors, while only 10% reported that their palliative care knowledge came from their cardiovascular training. The survey also asked the doctors how interested they would be in palliative care education. Well over half indicated significant interest.
Palliative Care Teams
With such an interest in providing a more comprehensive approach to treatment, why is there still a gap in providing it? Education is part of it. As more and more awareness is created, maybe one day palliative care will become a regular part of specialty training. Maybe one day it will be seen as the standard of care.
This is where a palliative team comes into focus. Team members can make a more comprehensive assessment of the patient’s quality of life. They would be able work with a person’s family to gain a better understanding of how their condition affects daily life on an emotional, mental, and spiritual level. They can set up home visits and spend more quality time assessing and providing recommendations to meet a person’s needs.
Palliative care teams are growing in popularity. More and more doctors are coming to see the benefits that working with a care team provides, and not just in end-of-life circumstances. Cooperating with a palliative care team early on provides a more comprehensive approach to a doctor’s recommendations and treatment. It also increases patients’ satisfaction with their care providers.
People want to feel more understood and listened to. Palliative care is the means to bridging the gap between patients and doctors by prioritizing the patients’ goals and letting the patients’ voices be heard.
Alpert, C., Hummel, E., Hummel, S., Gauvreau, K., Bohannon, K., Cooper, S., et al. (2016).Mind the Gap: Palliative Care Knowledge Among Cardiovascular Clinicians. Journal of the American College of Cardiology, 67(13_S): 1553-1553. Available at http://content.onlinejacc.org/article.aspx?articleid=2509966#tab1. Last Visited April 12, 2016.
World Health Organization. WHO Definition of Palliative Care. Cancer. Available at http://www.who.int/cancer/palliative/definition/en/. Last Visited April 12, 2016.