Usually the conversation starts out with, “How do you say it? Pall-i-a-tive care? Is that three syllables or four?” Then the eyebrows furrow with the typical follow-up question, “What is palliative care?”
As a new fellow specializing in palliative medicine with Summa’s Palliative and Hospice Services, this question is posed to me by family, friends, patients and just about anyone who hears me use the words “palliative care.” I’ve found that during a short conversation with someone, it’s hard to give a brief description of what it means, what we do, and why it is so important.
Sometimes, experts give the quick response of, “Palliative care – oh, that’s hospice.” Unfortunately, many people, including doctors, often interchange the words palliative care and hospice – confusing patients and family members alike. Instead, I try to explain palliative care by saying, “All hospice is palliative care, but not all palliative care is hospice.” This means that hospice is only a small piece of the larger umbrella we call palliative medicine.
What is Palliative Care?
- Palliative care is specialized medical care for people with serious illnesses.
- It focuses on relieving patients from the symptoms, pain, and stress of a serious illness no matter the diagnosis.
- Care is appropriate at any age and at any stage of a serious illness, and can be provided with a curative treatment process.
- A team of doctors, nurses and other specialists provide the care and work with a patient’s other doctors to help provide an extra layer of support.
- The goal is to improve the quality of life for both the patient and the family.
When people have serious illnesses like congestive heart failure ( ), chronic obstructive pulmonary disease (COPD), renal (kidney) failure, cancer, dementia, HIV, multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS), they often have symptoms that are caused by the illness or the treatment. These symptoms, such as pain, nausea, anxiety, loss of appetite, depression or shortness of breath, can range from being mildly annoying to distressing and impacting a patient’s daily life. Our goal in palliative care is to help relieve patients from these symptoms and the stress of their illness so they can live the best life possible.
The Palliative Care Team
There is really strength in numbers on the palliative care team. Different people bring different perspectives, which offers patients a better chance to have their needs met. The team consists of doctors, nurse practitioners, nurses, pharmacists, social workers, psychologists, chaplains, massage therapists and volunteers. If one person can’t provide what the patient needs, often another member of the team has a different idea that fits the patient.
Take pain for example. When someone says they are having pain, we really try to tease out what type of pain they are experiencing, since certain medications alleviate certain types of pain better than others. And pain is often multifactorial, meaning that not only can pain originate physically, but it can also be magnified by emotional or psychological issues. As a team, we help to identify these issues and work to resolve them or help patients deal with whatever they may be facing in their lives.
Similarly, if someone is experiencing shortness of breath (which often relates to anxiety) we treat the symptoms acutely, look for the causes, and attempt to improve the person’s quality of life along the way. And when people are hit with a serious diagnosis – whether curable, chronic or life-limiting – they often (and understandably) become anxious or depressed. Whether they need medications or a listening ear, we are available to offer support.
It’s hard to explain all that we do. Each patient is different, and our treatment varies depending on the individual and the cause of his or her symptoms. However, all in all, we like to pride ourselves on the fact that we “think outside of the box” and help provide the best quality of life for our patients and their families.
Franciska Kiraly, M.D.
Hospice and Palliative Medicine Fellow
Summa Health System