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Palliative Care: Prolong Life and Reduce Suffering in Patients with Serious Illness

5/23/2011 12:20:08 PM

Americans are just beginning to learn about palliative care and how it can complement traditional home care for people facing serious illness. The goal of palliative care is to control pain and symptoms of serious illness and improve quality of life. According to the AAHPM, palliative care focuses on treating the person, not the disease.

Palliative Care and Home Care

“Most people who get palliative care are still in their own homes,” said Dr. Porter Storey, executive vice president of the American Academy of Hospice and Palliative Medicine.

According to Dr. Storey, in Europe, Canada, and Australia, palliative care and hospice care are synonymous, but in the United States, palliative care is also used when people are still pursuing a cure for their illness. Because of U.S. government rules, hospice is limited to those with six months or less to live.

A recent study that was published in the New England Journal of Medicine of 151 patients determined that of the 86% of surviving patients, “Patients assigned to early palliative care had a better quality of life than did patients assigned to standard care.” In addition, survival was longer in those who received early palliative care.

The New England Journal of Medicine study also stated that palliative care programs have the potential to reduce hospital expenditures—an important issue in a time of rising health care costs.

A Team Approach to Serious Illness

Palliative care is provided by a team of professionals—including doctors, nurses, social workers, nutritionists, chaplains and others—who have received board certification specifically for palliative care. The team works in conjunction with the patient, in home caregivers and other loved ones, as well as with the patient’s own doctor.

“Once you’ve decided to end the aggressive treatments and therapies, it’s time for palliative care,” said Alex Morrison, Homewatch Caregiver’s field sales and support manager in Denver, Colorado. Mr. Morrison’s parents died within 36 hours of one another in March. “It substantially improved their quality of life before dying, which gave me piece of mind during a very difficult time” he said of his choice to get them palliative care.

Although Mr. Morrison’s parents did not enter palliative care until near the end of their lives, he said it was the best way to eliminate additional suffering caused by bad medication interactions. Experts do recommend palliative care for patients soon after their diagnosis with a serious illness for this reason, among others.

Meeting a Range of Needs

Often people seek-out palliative care to deal with the physical pain of their illness and its treatment. At both AAHPM and The Center to Advance Palliative Care, there are stories of actual patients who had palliative care and how it benefited them or what they hoped to get from it.

These stories are about people with illnesses such as lung disease (the study written about in the New England Journal of Medicine focused on patients with newly diagnosed metastatic non-small-cell lung cancer), cancer, dementia, liver failure, heart disease and many more.

And while some of these are survivor stories, Dr. Storey said that people can and should seek out palliative care when they are not certain of the possible outcomes. “There are more and more medical treatments for people who are really sick,” he said. “Lots of people are in this limbo and not ready for hospice.” This is where palliative care comes in and has been developed to address the questions patients and their families may have about treatments, home care resources, and more.

Palliative care is now available in at least 70% of U.S. hospitals (those with over 300 beds), and a directory on the Center to Advance Palliative Care website, provides a list and links to those facilities. Non-hospital-based palliative care can be found at www.caringinfo.org.

Not only does palliative care assist patients with serious and life-threatening illness, but also their caregivers. “Families really don’t know what to do,” said Dr. Storey. “And they are concerned about what to do next.”

Dr. Storey said that both hospice and palliative care should be used sooner by patients and their loved ones. “Hospice is still a wonderful, wonderful service that people don’t elect to use early enough. And hospice has the widest array of services in the home,” he said. “It’s not like palliative care is a substitute for hospice. It’s a marvelous support for the caregivers and should be used sooner.”

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