By Travis Austin, MD
Palliative Care is specialized medical care for people with serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.*(This definition is from the Center to Advance Palliative Care)
If you or a loved one faced a life-threatening illness like advanced cancer or dementia, what would be important to you? High quality medical care would be important, but the purpose behind that care would likely be something bigger: quality time with family and friends, reduced pain or other symptoms, a longer life, increased spirituality, or any number of other values and goals important to you.
Understanding these values and supporting patients and their loved ones in receiving care that most aligns with those values lies at the heart of the palliative care specialty. The lived experiences of patients with serious illnesses like cancer, heart failure, COPD, dementia, kidney disease, and neurologic disease includes and goes beyond medications, diagnoses, procedures, and other treatments. Their medical experience is important, but so are the emotional, social, psychological, cultural, and spiritual dimensions of a person, their family, and their friends. Palliative care sees the person beyond the disease.
Since palliative care is a relatively new medical specialty, there are some common misconceptions. First, palliative care is team-based. Palliative care teams include specially trained doctors, nurses, social workers, chaplains, volunteers, and other specialists. The team works together with primary care and other specialist physicians to provide an extra layer of support. Patients continue to see their regular primary care physician and other specialist doctors, and the palliative care team works to ensure coordinated care.
Furthermore, palliative care is appropriate at any age and at any stage in a serious illness and it can be provided along with curative treatment. Patients receiving palliative care might receive palliative care services for years while continuing to receive curative treatments and will sometimes even be cured of their illnesses while still receiving palliative care.
Sometimes there is confusion about the difference between palliative care and hospice, and it is important to recognize that these are two very different services. While both focus on symptom relief and quality of life, a patient can only enroll in hospice if they have a limited life expectancy and are no longer seeking curative treatment. As explained previously, palliative care has no such limitations. However, hospice care provides benefits that many palliative care services cannot provide, so palliative care providers can also help people decide when hospice is right for them and can assist in that transition when appropriate.
Palliative care can be provided in the hospital, at home, or in long-term care or assisted living facilities, depending on the patient's situation. However, palliative care itself is not a “place” that people live and receive full-time care. We are happy to work together with these facilities and with home health, but do not provide the same services. Like most medical specialties, palliative care is appointment-based. These appointments are covered by insurance and usually require your regular copay.
As a medical resident, I met many people who received wonderful care from their knowledgeable medical providers, but still described great suffering in their lives. Often, this included the effect of their illness on family members, uncontrolled symptoms, uncertainty about how to plan for the worst while still hoping for the best, unpredictability about the course of their illness, and more. To become certified in palliative care, I received extra fellowship training beyond residency. I was trained to manage symptoms related to serious illnesses, to communicate with patients and families about their illness, to plan for the future with both realism and hope, to assist in making difficult decisions, and more. I learned to work with an interdisciplinary team to provide whole-person medical care, and I saw that care play a role in relieving suffering. It doesn’t make the experience easy, but I saw patients and families living well and being their best selves despite the inevitable chaos, uncertainty, fear, and hurt that comes in living with a serious illness.
The diagnosis of a serious, life-threatening illness presents new challenges for patients and families, yet time and time again I’ve seen how people rise to these challenges and even manage to discover new growth and resilience. As a palliative care physician, I’m thankful that I have the opportunity to work with my team to support people through these difficulties.
If you think you or a loved one might benefit from palliative care, you can ask your doctor for a referral or you can request an appointment by calling 928-358-7061. If you are unsure whether palliative care is right for you, we are happy to set up an initial appointment and discuss. You can also learn more at getpalliativecare.org