Palliative care is relief from the pain, symptoms and distress of serious illness. Its goal is two-fold:
- To ensure the highest function and quality of life possible.
- To organize support for patients and families so they can achieve their goals.
Palliative care is appropriate at any stage of an illness that may limit life and can be offered alongside treatments intended to cure.
Palliative care is provided by interdisciplinary teams of physicians, nurses, social workers, spiritual care providers, as well as other professionals with expertise in giving the support needed to navigate the many life-limiting illnesses. Palliative care teams often work closely with a patient's primary physicians to assist with:
- Pain and physical symptom management.
- Clear communication with the patient and family.
- Difficult or complex treatment decisions.
- Managing care transitions.
- Detailed and practical help at all stages of care.
- Emotional and spiritual support for the patient and family.
Palliative care can be provided to any patient and family living with a serious illness. Key indications for palliative care involvement include, but are not limited to:
- Uncontrolled pain, physical or emotional symptoms related to serious illness.
- Declining function and capacity to provide activities of daily living.
- Progressive weight loss.
- Multiple hospitalizations.
- Uncertainty regarding prognosis.
- Uncertainty or conflict regarding goals of care.
- Do not resuscitate (DNR) conflict.
- Use of tube feeding or total parenteral nutrition (TPN) for patients with cognitive impairment or advanced illness.
- Family or provider questions about appropriateness of hospice care.
- Caregiver or family distress; need for resources.
Palliative care can be integrated at any stage of an illness that may limit life. It can be offered in acute care hospitals, assisted living facilities, nursing homes and a variety of outpatient settings.
Hospice always provides palliative care, but focuses on terminally ill patients no longer seeking curative therapies and expects that patients will have six months or less to live. Palliative care can be provided alongside curative care and can be initiated at any point, even at time of diagnosis.
Palliative care programs are growing nationwide and are present in more than 2,000 acute care hospitals. In addition, Palliative Medicine has been granted official subspecialty status by the American Board of Medical Specialties and fellowship training has been recognized by the Accreditation Council of Graduate Medical Education.