Understanding Palliative Care

Kathleen Lynch, RN
Administrator of Admitting, Intake and Outreach Services
Calvary Hospital

Palliative Care and Hospice have existed for decades in this country. Although much has been written about both topics, there is ongoing confusion in the medical community and with the general public about how to define each of those terms and when to bring that care into a person’s life.

The goal of this article is to help better define and describe palliative care and the variances of care available to help make finding appropriate care for your loved one a bit less overwhelming.

What is Palliative Care?
Palliative care means comfort and support for patients with serious illnesses. Specialized medical providers focus on relieving pain and associated symptoms, reducing stress, and generally improving quality of life for patients and their families. Palliative care can be given while other ongoing treatments are being applied. This aspect sets palliative care apart from hospice care. That is, hospice care is aimed at comfort as patients approach the end of life.

Who Receives Palliative Care?
Anyone with a serious illness, chronic, or life-threatening disease, regardless of age or stage of illness. The conditions most commonly treated by palliative care are heart disease, cancer, stroke, diabetes, kidney disease, Parkinson’s, and Alzheimer’s disease.

Who Provides Palliative Care?
Palliative care crosses all medical disciplines and specialties. Doctors, nurses, and social workers specialized in palliative care collaborate with a patient’s existing medical team to provide palliative care and support.

Where Does Palliative Care Happen?
Patients can receive palliative care in hospitals, outpatient clinics, or at home.

Who Pays for Palliative Care?
Palliative care is covered in the same way as medical care. Most insurance plans, including Medicare and Medicaid, cover all or part of palliative care. Social workers trained in palliative care can help patients navigate coverage.

What Does Palliative Care Include?

• Symptom Relief – Palliative care providers specialize in comfort and relief from pain and other symptoms including shortness of breath, fatigue, constipation, nausea, loss of appetite, and difficulty sleeping. These measures help patients continue everyday activities and support them as they receive medical treatment.
• Communication and Coordination – Palliative care practitioners also specialize in communication, by listening to patients and their families and making sure their medical questions are answered and that they understand the full breadth of their treatment options. Also, they coordinate and collaborate with the medical team, improving the efficiency of care.

Why is Palliative Care Important?

• It’s Beneficial to Patients – A 2010 study in the New England Journal of Medicine, reported that lung cancer patients receiving early palliative care had improved quality of life, less depression, and survived 2.7 months longer.
• It Saves Money – By coordinating care and increasing efficiency, palliative care teams can reduce costs. These measures translate to cost savings through shorter ICU stays; shorter hospital stays, reduced pharmacy costs, fewer unnecessary tests, and increased efficiency in care transitions.Approximately 68 percent of Medicare costs originate with patients with four or more chronic conditions—potential palliative care patients. Currently, over 1,700 hospitals have a palliative care team. Among hospitals with 50 or more beds, approximately 67 percent offer palliative care. Full implementation at every U.S. hospital could translate into savings of $6 billion per year.
• The Population of Potential Palliative Care Patients is Growing. Expected growth in the population of elderly Americans will translate to increased numbers of people with serious illness. Right now there are about 90 million Americans living with serious illness. This number is expected to more than double over the next 25 years. The number of palliative care teams has increased by 164 percent over the past 12 years.

How Do I Get Palliative Care?
If possible, choose a facility with a palliative care team. Review the palliative care national and state-by-state report card here.

Tell your medical team that you would like to meet the palliative care team. It is recommended to start working with a palliative care team in the early stages of medical treatment if possible.

Why Calvary?
Calvary Hospital is the only fully accredited acute care specialty hospital in the U.S. exclusively providing palliative care for adult patients with advanced cancer and other life-limiting illnesses. Our programs include inpatient care, pain management, hospice, home care with bereavement, and support programs for families and friends. Contact us for more information on our hospice and palliative care services.