What is palliative care?
Palliative care is a medical specialty focusing on management of symptoms in patients with acute, chronic or life threatening illness, regardless of the diagnosis. These symptoms might include, but are not limited to, pain, nausea, shortness of breath, fluid retention, etc. Palliative care strives to help patients better understand treatment options and customize treatments to meet individual needs. The goal is to promote the highest quality of life for patients and their families.
How does palliative care work?
Palliative care can be delivered any time during a patient’s illness while they are being treated in a hospital. Palliative care can be provided throughout treatment for a serious illness and may be provided in conjunction with all other medical treatments. While striving to achieve medical management of an illness, palliative care addresses a person’s symptoms and physical needs.
The palliative care team
Palliative care uses an interdisciplinary team of health care professionals to address physical, emotional and spiritual needs. It looks at the whole person, which also includes family members. The palliative care team works with you and your family to establish individualized goals of care. Regular family meetings are an essential component of the palliative care program.
The palliative care team includes:
- Primary physician
- Palliative care medical director
- Palliative care nurse practitioner
- Certified palliative care nurses
- Case managers
- Social workers
- Rehabilitation specialists
- Benefits of palliative care
The palliative care team supports you and your family every step of the way, not only by controlling symptoms, but also by helping you understand treatment options and goals. The palliative care team also works with your physician to provide an extra resource for support.
The benefits of palliative care include:
- Expert management of pain and other symptoms
- Education for patients and families about the disease process, treatment options and prognosis
- Help in understanding treatment options and goals of care
- Help with navigating the healthcare system
- Emotional and spiritual support for patients and families
- Help identifying spiritual or religious concerns
- Help with advance care planning
- Help with accessing community resources
How does palliative care differ from hospice care?
Palliative care is available at any time during a serious or life-threatening illness. It is for patients receiving treatment who need help managing pain and other symptoms. Hospice care is for terminally ill patients with a prognosis of six months or less if the disease runs its normal course and curative or life-prolonging treatments have been stopped. You do not have to be in hospice to receive palliative care.
How to get palliative care
Ask your doctor for a referral to get palliative care services. While you are in the hospital, the palliative care team can help you.
Tips to help you talk to your doctor about palliative care:
- Tell your doctor you are considering palliative care and ask what palliative services are available in your area.
- Ask your doctor to explain your illness and treatment options.
- Explain to your doctor what quality of life means to you. This list may include being able to spend time with loved ones, having pain and other distressing symptoms treated aggressively, the ability to make your own decisions for care and your preferred location of treatments (home vs. in the hospital).
- Be sure your doctor is aware of any personal, religious, or cultural beliefs, values, or practices that are important to consider in your care and treatment decisions.
- Tell your doctor what curative treatments you may or may not want, such as resuscitation if your heart were to stop, being placed on a mechanical ventilator if your lungs were to fail, undergoing dialysis if your kidneys were to fail, and artificial nutrition by a feeding tube if you become unable to eat.
- If you have completed a living will or health care proxy, be sure to inform your doctor and provide him or her with a copy.
- If you are suffering with pain and other symptoms because of a serious illness, ask your doctor for a palliative care referral.
About our Medical Director
David Wooten, MD
David Wooten, MD, is the medical director of Hospice and the new Palliative Care program at Covenant Health. Dr. Wooten brings 18 years of experience directing hospice and palliative care programs, in addition to an internal medical career that spans nearly three decades. Board certified, Dr. Wooten is a graduate of the University of Tennessee, UT College of Medicine, and a fellow of the American College of Physicians.
“Palliative care sees patients in hospital intensive care units who have a poor prognosis,” Dr. Wooten explains, “and helps patients and families decide when it is appropriate to withdraw care that is likely to be ineffective or contradict patient wishes or advance directives. Palliative care focuses on management of symptoms such as pain, nausea, shortness of breath, or other symptoms that may be distressing,” says Dr. Wooten. “We see patients with cancer, chronic medical illnesses including dementia, heart and lung disease, advanced liver or kidney disease, and any patients with a life threatening illness.”
Dr. Wooten says palliative care is different from hospice care in that hospice is usually intended for patients who have six months or less to live and requires most patients stop aggressive or life prolonging treatments. Palliative care provides help for patients after life-limiting diagnoses, but before they are ready for hospice. It can be appropriate for a variety of diagnoses including:
- Heart Disease
- Lung Disease
- Advanced Liver Disease
- Advanced Kidney Disease
Palliative care can be helpful in providing comfort and management of symptoms such as:
- Chronic pain
- Shortness of breath
Palliative care is a medical specialty, and can be accessed by making a request to a patient’s attending physician.