Palliative care, what’s it?
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Knowing that a patient is terminally ill but still providing medical help, not to cure, but to relieve symptoms.
quality of life treatment is palliative care. Issues like stress, pain, emotional, etc are addressed, but not specifically the ailment the patient is suffering,
At some point it’s no longer possible or reasonable to target a cure or meaningfully extend life, so medical treatment then switches to “palliative care”
The idea is that the patient is effectively doomed, and steps should be taken to *minimze* suffering instead of *extending* it with aggressive treatment that only adds a few miserable weeks of life.
Say your 93 year old grandmother has a colossal stroke and is left paralyzed and minimally responsive. Do you keep her alive indefinitely in the ICU at great cost and agony, or turn up the painkillers and let her go? It’s an ethical decision that must be made when the end of life is no longer avoidable, but different people have different opinions on exactly when it should be made.
If a patient has a terminal medical condition (they are going to die), and there are no treatments that can be done to cure the problem/disease, then they are “made comfortable” with palliative care.
Palliative care patients are either kept in the hospital or sent home (depending on the severity of their condition), and prescribed medication (including painkillers) so that they don’t suffer during their last days. The medication can’t cure (nothing can), so it’s there just to reduce pain and suffering. Typically, if sent home, a nurse will come by to visit and check up (medically) on the patient, and possibly there’s therapy also offered to the patient and the family to deal with the emotional side of the patient’s eventual (sometimes soon) death.
It’s basically about treatment where the goal is not to cure, but rather to manage symptoms and alleviate suffering.
For example, if someone is dying of lung cancer and there is no cure available. Just because there is no cure doesn’t mean we can’t do anything.
They can still get chemotherapy and radiotherapy to try to shrink the tumours or buy them more time. They can get painkillers to alleviate their pain. They can get laxatives to treat their constipation. They can get anti-sickness medication to treat their nausea. They can get sleeping tablets to treat their stress-related insomnia. They can get benzodiazepines to treat their anxiety. They can get oxygen and morphine to treat their breathlessness. They can get subcutaneous fluids to treat their thirst once they can no longer swallow. They can get antihistamines to treat itch caused by liver failure. They can be put in touch with support groups, religious ministers, cancer support charities, hospices, financial aid agencies, home carers, etc to treat their psychological needs.
Everything I mentioned here, and more, would come under palliative care.
Palliative care is care that is designed to provide comfort and relief for patients, rather than trying to cure or treat the underlying disease. Unlike what a lot of people here are saying, it doesn’t *always* mean somebody is dying. You can give palliative care for patients who are being treated for cancer to help with pain, nausea, etc, and it doesn’t mean that they’re dying or that other treatment has to stop.
Palliative care in the setting of terminal illness also doesn’t mean discontinuing all medications or other potentially lifesaving treatments, and it doesn’t mean “hastening death”; it’s a decision to be made by the patient/family/doctor. For example, a patient with terminal cancer might want to stop a chemotherapy regimen with nasty side effects, but might still be taking their medications to make sure they don’t have a heart attack. It really depends on the individual case!
These might seem nitpicky, but this is really important–a lot of people think that providing palliative care means you’re “giving up” on the patient or that there’s no hope, which can discourage people from seeking it.
Palliative care is aimed at improving quality of life, including pain management, stress, emotional and psychiatric care, and can even extend to things like spiritual care.
Palliative care is typically used for patients with terminal illnesses and incurable conditions. It’s aim is to reduce suffering and improve their quality of life as best as possible given the circumstances.
My Grandfather for example spent the last 6 months of his life in a palliative care facility. There were no illusions that he wasn’t going to recover from heart + respiratory failure so they focused on pain management and had an active DNR.
The facility allowed for 24/7 visitation by family and had an adjacent room where you could stay, relax, and even sleep if required. That way at least one of us was always present until he inevitably passed. They also had a priest oncall that would make frequent visits, which was important to my grandfathers well being.
Its quality of life care. Often for patients with illnesses or ailments that are life threatening or uncurable. I do some charity work for a great company that provides palliative care for a lot of older people with terminal illnesses called ACCORD hospice. Check their website. It has a lot of info on what they do.
People with cancer for example will receive physical care such as dealing with nausea and loss of appetite, fatigue, difficulty sleeping. As well as emotional care for things like coping with depression, anxiety, fear of their impending death. This kind of crosses the palliative/hospice care definition though. Palliative turns into hospice care when the treatments are simply to make someone who is dying as comfortable as possible. Palliative care is still caring for a non terminal patient to enable them to live comfortably and to enhance any chances of curative treatment. Palliative/Hospice care is mainly semantics in the US. We just use palliative here in the UK.
Cancer patients will obviously deteriorate over time with chemo treatment and palliative care also helps with the transition to a fragile state both phsyically and mentally.
They also can provide support to family and friends. Theres a charity here called McMillan for cancer patients that provide amazing support to families going through a cancer diagnosis/treatment. Ranging from support with coping emotionally or even every day things like sorting finances in preparation for the worst outcome.
Here in the UK, we use the term palliative care for any stage of the care of a seriously ill person from diagnosis to death.
When someone is dying and you can’t stop that, but we want them to feel comfortable and cared for instead of just leaving them in the woods for the wolves to find.
Departing with dignity.
One thing I have not seen in the comments is that Palliative care is NOT hospice. Hospice is caring for the person who is imminently dying.
It can be for something like MS, ALS, Lupus, long term cancer.
Palliative care can last 10 years or a month.
It is more about the patients wellbeing as a whole while they deal with the disease.
This is a good site: https://www.massgeneral.org/cancer-center/treatments-and-services/palliative-care/
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