Palliative Care Provides Comfort and Support alongside Cure-Seeking Treatments
Although you may often see the words “palliative care” listed in conjunction with “hospice care,” the two terms are not entirely interchangeable.
“Palliative care can take on different meanings for different people,” Sandy Sferrella-Taylor, public relations manager for Visiting Angels York, said.
“Palliative care seeks to prevent, relieve, or soothe the symptoms of disease, disorder, or aging without effecting a cure. It is a resource for anyone living with a serious illness where doctors feel they can provide treatment in the hopes of a cure.”
Both palliative care and hospice care provide symptom management and comfort care for people with serious illnesses, but palliative care — which also supports a patient’s emotional, social, and spiritual needs — is not restricted to those with a life-limiting illness.
“Some people are more comfortable with the term ‘palliative care’ if the explanation of support and comfort is provided,” Sferrella-Taylor said. “Many people associate the term ‘hospice’ with ‘giving up’ or death in general. The expectation of death to be coming soon does not need to exist to receive palliative care.”
Hospice care is a type of palliative care, but not all palliative care is hospice care, which is reserved for individuals diagnosed with a terminal illness and with a life expectancy of six months or less. Patients who choose hospice have chosen to end curative treatment, but “diagnoses and life expectancy are not part of the need for palliative care,” Sferrella-Taylor said.
There is no time limit for palliative care; it is appropriate at any stage of a serious illness and for patients of any age.
Palliative care can occur in a hospital, in outpatient settings, in assisted living facilities, or at home. It is provided by an interdisciplinary team assembled based on the patient’s particular needs: palliative doctors, nurses, dieticians, pharmacists, social workers, financial advisers, and other specialists.
This team works in conjunction with a patient’s physicians to provide “an extra layer” of comfort and support, according to the Center to Advance Palliative Care (www.getpalliativecare.org).
A palliative care team may help someone with a serious illness — such as cancer; heart, lung, or kidney disease; Alzheimer’s; multiple sclerosis; and others — to better carry on with their daily life.
The types of relief received under palliative care depend on the patient’s individual needs and can include medication or other treatments for physical discomforts such as pain, fatigue, sleep disruptions, nausea, constipation, or appetite loss.
It could also include trained caregivers and social workers to help a patient better understand their diagnosis, clarify treatment goals and options, and offer emotional support as they deal with the stress and anxiety that arise from the management of their illness.
“[Palliative care] can be for anyone needing comfort care … they might not be nearing the end of life or willing to put off any life-sustaining measures,” Sferrella-Taylor said. “They might still be receiving aggressive treatments for certain illnesses. Therefore they wouldn’t necessarily qualify for hospice, but they can get palliative care.”
For someone already facing the costs of treating their disease, the addition of comfort care, while appealing, may not at first seem financially viable. But many private insurance companies and health maintenance organizations (HMOs) offer palliative and hospice benefits, according to PalliativeDoctors.org, the patient site of the American Academy of Hospice and Palliative Medicine.
For people over 65, Medicare Part B offers some palliative care benefits; Medicaid’s coverage of palliative care varies by state.
Sferrella-Taylor said the nature of the palliative care being provided often determines whether or not Medicare will pay for it. Non-medical care is not usually covered, but if the palliative care is categorized as nursing care or therapy, it may be covered.
“An example of such care may be nursing visits from a skilled homecare agency to the end-stage congestive heart failure patient to manage them at home with the goal of avoiding repeat emergency-room visits,” Sferrella-Taylor said. “This type of care also provides comfort and support, but the inclusion of the licensed professional may make it a Medicare-covered benefit.”
How does someone diagnosed with a serious illness obtain the care of a palliative team? By asking for it. Hospitals often have a palliative specialist, or personal doctors and nurses can refer a patient to a palliative doctor. There are also numerous online resources that can serve as starting points for assembling a palliative-care team.
The essential goal of palliative care is to alleviate physical suffering and mitigate the emotional and psychological burdens that accompany long-term medical treatment.
“Many individuals, especially our clients, receive palliative care on an ongoing basis,” Sferrella-Taylor said. “The key is support and comfort for individuals who need it, and that, as mentioned, can span several years.” BW