Expert Health Articles

Palliative Care

Dr. Christian JacobusDr. Christian Jacobus

Hospice and Palliative Care, Bridge Home Health & Hospice 

In a previous Weekend Doctor column about choosing a hospice provider, I mentioned palliative care services. Palliative care is a medical specialty with which most people are not familiar, so I’d like to give you an introduction.

In short, palliative care is whole person-centered treatment for the symptoms that come with a serious illness. The goal of palliative care is to improve quality of life. The word “palliative” comes from the Latin word “cloak” and means to ease without curing. Symptom management is a big part of palliative care: pain, shortness of breath, nausea, constipation, anxiety, insomnia, itching and confusion - all of these are symptoms that can negatively impact a person’s quality of life and are treatable. Palliative care focuses less on treating a disease than on treating symptoms. I tell my patients, “Your other doctors focus on helping you live longer; I focus on helping you feel better.” Often, this means addressing social, psychological and spiritual issues as well.

The other big part of what we do in palliative care is discussing what we call “Goals of Care.” This means we get to know our patients and their families, their values and beliefs, what makes them unique, and what they’re hoping for from their medical care. We then take a bird’s-eye view of their care as a whole and assess whether it is meeting their goals. If it is not, we work with their other doctors and suggest changes to make it more aligned. This may mean changing current treatments or putting plans into place for the future—such as a living will, healthcare power of attorney or do not resuscitate order—to ensure patients get the treatment they want and only the treatment they want.

Palliative care can be delivered in any setting: hospital, home, nursing home or clinic. My nurse practitioners and I typically see patients wherever they call home about once a month. We assess symptoms, ensure understanding of the disease and prognosis, continue to address goals and coordinate care with the other physicians.

As a newer specialty, there are a lot of misconceptions about palliative care, even among physicians. These are some of the facts:

  • Palliative care is not just for patients with a terminal disease or cancer, it’s appropriate for anyone with any type of serious medical problem.
  • Palliative care and hospice are not the same thing. Hospice is a very particular type of palliative care that is just for those we believe have less than 6 months to live and who are ready to switch from life-prolonging to comfort-based medical care.
  • Palliative care can be given alongside traditional medical care like chemotherapy, surgery and IV antibiotics, and patients do not need to have a terminal diagnosis.
  • Our goal is not to get patients to stop their medical care; our goal is to make sure the care they’re getting is the care they want and that it is aligned with their goals.

If you think palliative care may be right for you, please talk to your doctor. For more information you can call Bridge Home Health & Hospice or visit the webpage for the National Hospice and Palliative Care Organization at caringinfo.org.