Comfort care

The goal of palliative care is to help the patient with a serious illness feel better. It prevents or treats symptoms and side effects of disease and treatments. Palliative care also treats emotional, social, practical, and spiritual problems that illness brings up. When the patient feels better in these areas, he or she has an improved quality of life.

Palliative care can be given at the same time as treatments meant to cure or treat the disease. You may get palliative care when the illness is diagnosed, throughout treatment, during follow-up, and at the end of life.

Palliative care may be offered for people with illnesses such as cancer, heart disease, lung diseases, kidney failure, dementia, HIV/AIDS, and ALS (amyotrophic lateral sclerosis). You do not need to give up your doctor or your treatments to get palliative care.

Any health care provider can give palliative care, but some specialize in it. Palliative care may be given by a team of doctors, nurses, registered dietitians, social workers, psychologists, massage therapists, and chaplains.

Palliative care may be offered by hospitals, home care agencies, cancer centers, and long term care facilities. Your doctor or hospital can give you the names of palliative care specialists near you.

Both palliative care and hospice care provide comfort.

• Palliative care can begin at diagnosis, and can be given at the same time as treatment.
• Hospice care begins when it is clear the patient is not going to survive the illness and after treatment of the disease is stopped. Hospice care is usually offered only when the person is expected to live 6 more months or fewer.

A serious illness affects more than just the body. It touches all areas of life, and the family’s life. Palliative care can address these.

Physical problems. Some symptoms or side effects include pain, trouble sleeping, shortness of breath, loss of appetite, and feeling sick to the stomach. Treatments may include medicine, nutrition, physical therapy, or integrative therapies.

Emotional, social, and coping problems. Patients and family face stress during an illness that can lead to fear, anxiety, hopelessness, or depression.

• Family members may take on care giving too. Many family members also have jobs and other duties.
• Treatments may include counseling, support groups, family meetings, or referrals to mental health providers.

Practical problems. Some of the problems brought up by an illness are practical, such as money or job problems, insurance questions, and legal issues. The palliative care team may:

• Explain complex medical forms or help families understand treatment choices
• Provide or refer families to financial counseling
• Help connect you to resources for transportation or housing

Spiritual issues. When people are challenged by illness, they may look for meaning or question their faith. The palliative care team may help patients and families explore their beliefs and values so they can move toward acceptance and peace.

Tell your doctor what bothers you most and what concerns you most. Tell your doctor what is important to you. Give your doctor a copy of your living will or health care proxy.

Ask your doctor what palliative care services are available to you. Palliative care is almost always covered by health insurance, including Medicare or Medicaid. If you do not have health insurance, talk to a social worker or the hospital’s financial counselor.

Learn about your choices. Read about advanced directives, deciding about treatment that prolongs life, and choosing not to have CPR (do not resuscitate orders).