What is Palliative Care?
Palliative (pa-lee-uh-tiv) care, sometimes referred to as “comfort care” is specialized medical care provided by trained professionals to improve the quality of life of patients for individuals in any stage of serious illness. The goal of palliative care is to provide relief from symptoms, pain and stress while improving the overall quality of life for the patient and their family.
Who is Palliative Care for?
Palliative care can be provided to any age individual in any stage of serious or life-threatening illness. This can be during the initial illness diagnosis, treatment, follow-up or end of life phase.
According to World Health Organization, most adult patients in need of palliative care have a chronic disease such as: cardiovascular disease, cancer, chronic respiratory diseases, AIDS, diabetes, or other chronic conditions such as: kidney failure, chronic liver disease, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological disease, dementia, congenital anomalies and drug-resistant tuberculosis. Every year around 40 million people require palliative care; however, only 14% actually receive the care and almost 80% in need live in low and middle-income countries.1
Related: Palliative Care for Dementia
Palliative Care Eligibility
Palliative care is often believed to be only for terminal illness; however, individuals at any age and any stage of illness can be cared for despite the condition being curable, chronic or life-threatening. Eligibility requirements include:
- A patient has been diagnosed with a serious or chronic illness
- The illness requires pain management and ongoing care
- Pain is not under control or there is an inability to care for self
- There are difficulties emotionally coping with the illness or the illness is hard to understand
- Curative treatment is no longer beneficial
- Unqualified for clinical trial
- Further curative treatment is ineffective
Next steps include asking the health care provider for a referral for a palliative care consult and palliative care specialist while navigating insurance coverage. Some people transfer in and out of palliative care or are cured and move out of it completely.
If a patient’s symptoms are under control or even non-existent, palliative care might not be necessary or referred. For those who are unsure, there is a palliative care quiz to help determine eligibility.
Is Palliative Care the Same As Hospice?
Hospice is, in a sense, a type of palliative care. While palliative care focuses on many aspects of symptom and stress reduction for serious and life threatening illness, Hospice focuses on end-of-life care for individuals with a year to 6 months of life expectancy. Unlike Hospice, palliative care can be done in conjunction with curative treatment. While palliative care is typically paid for by insurance and individuals directly, Hospice care is paid for by Medicare, Medicaid and insurance.
Related: Palliative Care vs Hospice
Goals of Palliative Care
Palliative care is made up of a holistic-focused multidisciplinary team working together, along with a curative treatment plan, in order to provide support in quality of life, reduction of stress, pain and symptoms.
Ideally palliative care begins with diagnosis and becomes a fundamental aspect to patient care. Palliative teams take an individualized approach by relieving symptoms that are physical, social, emotional or social.
Improve Quality of Life
While many assessment tools and definitions for quality of life exist and are personal to individuals, it is one of the main goals of palliative care teams to work with patients and families to have positive communication while ensuring quality of life values (such as physical, psychological, social, cultural and spiritual well-being as well as feelings of self-worth and value of life) are being met and improved.
Relieve Suffering, Pain & Symptoms
Therapies, medication and other treatments might be prescribed by a palliative care doctor to offset bothersome illness or treatment symptoms (such as pain, fatigue, constipation, shortness of breath, loss of appetite and difficulty sleeping). Along with physical management goals, plans may include psychological or emotional support such as providing medical information to patients and families, advocacy and spiritual guidance.
How Much Does Palliative Care Cost?
The cost of palliative care varies significantly depending on the location of the care provided (in-home vs hospital) as well as the level of care provided to a palliative care patient. In home care will typically range from $150 to $1,432 per day while in-hospital care will typically range from $461 to $1,046 per day. These costs may be offset by medicare or private insurance.
More Details: How Much Does Palliative Care Cost?
Palliative Care Team
Providing a holistic approach in order to improve quality of life and relieve symptoms such as pain, suffering and stress requires a diverse team of individuals with varied skills. The makeup of the palliative care team may be individualized for personal needs and goals. An example of a palliative care team may include:
- Team of doctors and physicians (such as general practitioners, cardiologist, psychiatrists)
- Nurse practitioners
- Allied Health Professionals (such as counselors, pharmacists, social workers, dietitians)
- Complementary Therapists (such as acupuncture, aromatherapy, yoga)
- Chaplain or religious leader
- Family, caregivers and community volunteers
Where is Palliative Care Provided?
Palliative care services are often provided in hospitals, outpatient palliative care clinics, nursing homes, assisted living facilities and at home. While palliative care can be provided at alternative locations on an as needed basis, such as emergency rooms, treatment centers and intensive care units or after moving into hospice or other end-of-life care facilities. To find local palliative care, visit this palliative care directory.
What is Included in Palliative Care?
Palliative care centers around the patient and their family with an emphasis on how things are operating on a daily basis. After being referred to a palliative care team, individualized plans will go into effect usually in conjunction with a curative treatment plan in order to establish good communication, meet goals that will improve quality of life and reduce the unpleasantries of illnesses.
Related: 5 Stages of Palliative Care
Meetings with palliative care service providers help determine symptoms and possible starting or stopping medications for relief. This holistic team of health care professionals also help decide on a plan for other forms of pain and symptom management such as a specialized diet or complementary therapies.
Palliative care may assist with equipment and address mobility and safety needs. Specific care is tailored to the individual and communication along with assessment tools may address unique needs and care options. The care plan may also include discussion of emotional and social concerns, spiritual needs, movement to hospice care and end of life wishes as well as advance directives.
Does Palliative Care Mean End of Life?
No, palliative care does not mean end of life care. It is provided as a supplementary support system in order to improve quality of life while managing pain, stress and other symptoms associated with any stage of illness regardless of age for both the patient and their family.
What Does it Mean to be Put on Palliative Care?
A team of specialized health care professionals work together to ensure quality of life is improved and relief from symptoms and stress are managed in various arenas of life. The purpose of palliative care is to ensure that daily life is manageable by meeting goals and personal choices of the patient and family. This can include:
- Assistance with understanding the illness itself
- Goals and medical options are made clear
- Symptom, pain and stress management
- Support systems for coping abilities
- Decision-making assistance and coordination with other doctors.
How is Palliative Care Covered
Coverage for palliative care can include self, private insurance policies, Medicare and Medicaid. Information for veterans and palliative care can be found here through the Department of Veterans Affairs. A social worker or financial consultant can come in handy when navigating payment of palliative care.
Related: Does Medicare Cover Palliative Care?
Are Medical Teams Changed when Placed on Palliative Care?
No. The palliative team is a support system alongside medical professionals diagnosing and treating the illness.
Is Curative Treatment and Palliative Care Done Together?
Yes. Palliative care can supplement curative treatment courses.
Who Benefits from Palliative Care?
The patient, family members and caregivers often benefit from the extra layer of support provided by palliative care. The patient has important goals and needs met while families offset a share of burdens with caregiving. Health professionals also benefit from improving the quality of patient lives and striving for better and longer life expectancy.
When and How to Ask for Palliative Care
Palliative care can be utilized at any age and during any stage of a serious illness and early in the illness yields the best outcomes. Ask a doctor for a referral for a palliative care consultation or to talk with a palliative care specialist.
- World Health Organization “Palliative care” 5 August 2020, https://www.who.int/news-room/fact-sheets/detail/palliative-care. 22 December 2021.