Palliative care is supportive care for someone who has a medical issue that changes their life in a significant way.  We talk about how this will affect one’s life overall, as well as the impact on daily life, considerations for treatment options, the emotional, psychological, spiritual and financial impact? How does this diagnosis impact one's functioning and how do you feel about this? There's a lot to unpack but what is uncovered in a Palliative care conversation begins to set the course for moving forward. 

Palliative care focuses on symptom management: fatigue, pain, shortness of breath, nausea, emotional distress (depression/anxiety) and sleep issues. Palliative clinicians look for ways to address the symptoms and to better understand how patient and patient’s supports are managing. Consultations generally include a physician, or a nurse/nurse practitioner, a social worker and sometimes a chaplain (patients may also choose to include their own spiritual support, e.g. a minister or other faith practitioner). All involved form what I call the patient’s “committee of support,” to discuss what they can offer, from medical consultation to psychosocial support. The conversations ultimately establish the patient’s goals for their care.

In Palliative care, the patient is not the only focus. Support is extended to those around the patient - partners, children, parents, friends - recognizing the patient is not the only one affected by the illness.

MYTHS

Palliative care is the same as Hospice. No, it is not. People can have the support of Palliative care while they continue their medical treatment.  Palliative care is a spectrum of support, from diagnosis through end-of-life decision-making.  Hospice is a service for patients in their last few months of life, usually offered in the home or a facility, when they stop active care for their life altering condition.

Palliative conversations are just for older people. Palliative conversations are for people with life-changing medical issues - a 23 year-old with cancer, a 36 year-old with end stage liver disease, a 50 year old with a new diagnosis of CHF or COPD, a 65 year old with a diagnosis of chronic kidney disease.  Palliative discussions address where the person is in life and how their decisions are shaped by their illness, their circumstances and the support they need.