Palliative Care

September 30, 2020

Written by the Open Caregiving Team. Editorial review by Joyce O. Murphy RN, MSN.

What is palliative care?

Palliative care is a form of special medical care for people who are seriously ill. It focuses on providing comfort, relief from pain and the best quality of life possible.

What does palliative care mean?

This form of specialized care means that:

  • Your loved one is being treated for a serious, chronic, or life-threatening illness.
  • Your loved one is interested in having as good a quality of life as possible while living with an illness.
  • Your loved one can have palliative care at the same time that they are being treated to cure a disease.

What does palliative care include?

Palliative care focuses on caring for your loved one holistically, as a whole person. It is concerned with your loved one’s emotional, social, spiritual, and practical life, as well as the illness they are hoping to manage.

Palliative care makes sure that the treatment options a person can have match their diagnosis.

  • A team of palliative care trained professionals answers your questions about care options and services. They explain how options help people with the illness your loved one has.
  • These are discussed with you and your loved one in order for you to make informed choices.

What are examples of palliative care?

Palliative care offers people a range of services, such as:

  • Adjusting pain medication as needed. This can happen frequently based on the disease as well as a person’s activity level.
  • Referrals to other specialists for other opinions and suggestions.
  • Social work services that help with getting personal health items or filling out insurance forms. They provide emotional support during life’s tough times.
  • Nursing and therapy services that provide care following a doctor’s orders. Therapies include physical and occupational therapy among others.
  • Additional service options such as massage therapy and aromatherapy to help manage pain and other symptoms.
  • Nutritional guidance about foods to eat for particular health conditions. This helps too with side effects of treatments by making suggestions for managing nausea, lack of appetite, or elimination troubles.

Who should receive palliative care?

Palliative care is offered to people of all ages with serious illnesses, including young children. The diagnoses people are living with include these, among others:

  • Serious diseases such as cancer and congestive heart failure (CHF).
  • Chronic illnesses such as crohn’s disease, chronic obstructive pulmonary disease (COPD), and kidney disease, among others.
  • Degenerative diseases including Alzheimer’s, amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease, and multiple sclerosis (MS).

People choose palliative care because:

  • They and their loved ones want care and comfort provided by professionals who are up-to-date with different types of care and service information.
  • They are interested in the forms of holistic and integrative care that focus on comfort and quality of life as well as treatments.
  • Their loved one has a serious or terminal illness and they want comforting care that may transition to hospice care.

Do people in palliative care ever get better?

There are people who get cured of illnesses such as cancer that are in palliative care.

  • The benefit of palliative care is that better life quality can positively affect health outcomes.
  • Palliative care helps to assure that treatment side effects are reduced, if possible. This can improve how a patient feels. They then eat better and are able to do things that support better health.
  • When a person’s disease is cured or improves, a person may be discharged. They can then have palliative care again if their health declines.

Who gives palliative care?

Palliative care is provided by a team of healthcare professionals who have special training. A patient’s team is made up of those who are best prepared to care for their illness and needs. The team members can include any of the following:

  • Doctors who are skilled in caring for people with various serious illnesses.
  • Nurses, nurse practitioners, and physician assistants who carry out doctors’ orders, or may also prescribe care.
  • Registered dieticians and therapists who follow the plan of care for needs such as:
    • Prescribed diets.
    • Support with breathing, movement, or living skills.
    • Helping to get equipment needed for care.
  • Social workers, counselors, and psychologists who provide support for:
    • You or your loved one’s emotional and social needs.
    • Preparing advanced directives and any other end-of-life wishes.
    • Completing paperwork for medical and health needs, including insurances.
  • Chaplains who provide spiritual care services for patients of all faiths.

What are the 5 stages of palliative care?

The stages of palliative care typically include the following. These can overlap, instead of a person moving from one to the next.

  • Diagnosis of a serious, chronic, or life-threatening illness.
    • Oftentimes a person has been ill for a while before a diagnosis is made of a serious illness. This can happen with a number of chronic and serious illnesses.
    • Once the diagnosis is made, you or your loved one know the extent of the illness. You have an idea of how it will affect life quality and length.
  • Having medical treatment involves talking about options to cure or care for your loved one’s illness.
    • This is the case with many forms of cancer or people in need of an organ transplant.
    • The medical treatment may include choosing medicine and therapies to reduce a disease’s symptoms. This is the care offered for heart and lung issues, among others.
  • Having care for pain and anxiety.
    • The illnesses discussed here often include these symptoms with one making the other worse. Care includes medications, as well as holistic care to promote comfort.
  • Taking part in therapy services is a stage that can be ongoing or reoccur based on need.
    • An example is having physical or respiratory therapy for a while and then again when a person’s health declines.
    • This applies to other services as well, including dietary counseling or massage therapy.
  • Preparing to transition is the final stage of life.
    • A person enters this stage when treatments to seek a cure are no longer working or desired.
    • This is determined by a doctor who offers an idea of how long a patient may live.
    • This can last for months or weeks, depending on how slowly or quickly a disease progresses.
    • At this point a person has the option of receiving hospice care that includes comfort care and family support.

Where is palliative care received?

Palliative care is a growing medical specialty. Because of this, it is offered in more communities and at different types of settings.

  • Palliative care can be provided at home, often by home healthcare agencies.
  • Palliative care is offered in hospitals or other facilities such as nursing homes.
    • Palliative care is available in many large hospitals and some that are small.
    • Many long-term care facilities, or nursing homes, now provide palliative care services.

Palliative Care vs Hospice Care

The primary difference between palliative care and hospice care is that palliative care is focused on seeking a cure or improving a person’s condition. When a person enters hospice, treatment for a cure stops. Despite this, the two have similarities that can cause confusion as they both:

  • Offer pain management and support a person’s comfort.
  • Involve a patient and their family in planning.
  • Can be provided in various settings, including home or a facility.

One key difference is that hospice care is suggested when a doctor determines that a person has six months or less to live.

How to find palliative care near me?

The Palliative Care Provider Directory is one place to refer to when searching for palliative care. Other options are:

Who pays for palliative care?

Does Medicare cover palliative care?

  • Medicare parts A and B cover many of the inpatient and outpatient services a person needs.
    • The amount of services covered depends on the care setting and type of care provided.
    • There may be copays with Medicare coverage when a person is in palliative care without hospice care.
    • Talk with a Medicare agent to learn about specific levels of coverage.
  • Medicare part C includes Medicare Advantage plans sold through private insurers.
    • They cover the same services as parts A and B.
    • Some may cover portions of prescription drugs and long-term care options.

What other health insurances pay for palliative care?

  • Many private health insurances pay a portion of palliative care services. Check with your health insurer to learn about what they will and won’t cover.
  • Your state’s Medicaid program may pay a portion of palliative care costs.
    • Eligibility for coverage and what is paid varies by state.
    • Call your state’s Medicaid office to learn more.

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Related Topics To Learn About

Hospice

Hospice care allows people with terminal illnesses and their families to live as comfortably as possible during the last stages of life.

Home Health Care

Home health care allows people who require medical care or are recovering from a hospitalization to remain at home.