The goal of palliative care is to help patients achieve the best possible quality of life, no matter what challenges their illness causes. Many people, in particular those with non-cancer conditions, miss out on this essential aspect of medical treatment because of limited understanding of how it can help them. A recommendation to begin palliative measures can lead to distress in patients and their families, because they may fear it means that the doctor is “giving up” on the patient, or that there is no hope.
Sometimes, despite the best efforts of the doctor or healthcare team, treatments may not succeed in halting the course of disease. At that point, further medical interventions will at best be ineffective, and at worst may cause harm to the patient. Treatments for very serious illness often have severe side effects, and can negatively affect the patient’s quality of life. If the benefits to the patient don’t outweigh those negative effects, the doctor will recommend stopping them. But that’s not the end of caring for the patient’s needs.
What is palliative care?
Palliative care is specialist care that is provided to help people live well with a life-threatening illness or in the final stage of life. It can involve the relief and ongoing management of severe pain and other symptoms; supervising the use of supplemental oxygen so the patient can breathe better; creation of an individually-tailored nutrition plan to counteract wasting and weakness; ongoing psychological support and emotional comfort.
In the past palliative care was usually associated with diagnosis of cancer. However this is no longer true, as many other conditions can require palliative care. Even if the patient has been told that his or her disease is considered “end-stage,” the palliative care professional strives to make each day more comfortable.
Palliative care can be an important part of treating different stages of life-limiting illness. The goal is always to help the patient achieve and maintain the best possible state of well-being and comfort. Care is provided by a team of professionals: doctors, nurses, psychologists, social workers, physiotherapists, nutritionists, complementary therapists and others. This may include, but is not limited to:
- Relief from pain or other distressing symptoms
- Spiritual, psychological and emotional support to affirm life and understand that dying is a normal process of living.
- Advice and support for carers to help cope during the illness, and bereavement care.
St Christopher’s Hospice (UK) founded in 1967, was the first modern hospice where expert pain and symptom treatment was linked to compassionate and humane care. Today palliative care is provided by a team of general and specialist providers. This includes providing everyday care to patients and the family, and specialist treatments from doctors and nurses. In the past palliative care was seen to be the domain of hospices and hospitals but the focus has evolved to providing care in patients’ homes so that they may continue to live in a familiar environment surrounded by their family. Other supportive complementary therapy services like massage and aromatherapy, acupuncture and nutritional supplements can make a considerable contribution to alleviating pain and discomfort, sleep, improving low mood and depression, and reducing other symptoms e.g. stress, nausea, tiredness and appetite.
Despite its long-term integration into standard medical practice, doctors can still find it uncomfortable to broach the subject of palliative care. The misconception that palliative care is the start of the last days of life can make it difficult for patients and families to discuss and accept.
In truth, palliative care is all about living–it is about being in control of your life and what you want to do. It offers you peace of mind, knowing that there is always someone for you to turn to for advice and reassurance. It allows your palliative care team to help you to find physical comfort and emotional acceptance of your circumstances, and a spiritual resolution for end of life planning. With this support you can still appreciate vibrant sunsets, and have a reason to wake up in the morning to a beautiful sunny day, full of aspirations and HOPE.