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Your advocates when you’re chronically ill

HCA Palliative Care

Over the past decade, palliative care has become an increasingly important branch of medical care, dedicated to providing comfort to patients with serious and chronic illnesses. The practice spans many subspecialties, requires a multidisciplinary team, collaborates with family members and uses a flexible approach to suit the specific needs of each patient.

“Palliative care improves the quality of life for patients and their families facing the problems associated with progressive illness, through the prevention and relief of suffering,” said Lorraine Goodwin, a palliative physician’s assistant at the Elaine Wynn Palliative Care Program and Southern Hills Hospital and Medical Center.

While palliative care can make a huge difference in a patient’s health, outlook and general wellness, it is considered a relatively new subspecialty and as such is often misunderstood.

What is palliative care?

The goal of palliative care is to improve quality of life — as defined by the patient, Goodwin says — when dealing with a serious illness.

Palliative care does not try to cure the patient but rather focuses on relieving his or her symptoms of pain, which can be physical, psychological or spiritual. Because that can involve complex and wide-reaching demands, the palliative care team can include physicians, nurses, therapists, social workers and chaplains. Team members work closely with the patient and his or her family to assess the patient’s individual needs and determine the best course of care.

Palliative care does not replace medical treatment, caretakers or supportive therapies; rather, the palliative care team works in tandem with other providers to lend patients additional support.

This can give patients a better understanding of their illness and the treatment they’re receiving, and can give a patient an ally during a time of extreme turmoil.

Who is eligible for palliative care?

The only requirement for receiving palliative care is having a serious, chronic illness. Regardless of the patient’s age — it is for children and adults — or the stage of someone’s illness, palliative care might be an option.

Patients with the following diseases are likely candidates for palliative care, though other diseases can warrant it as well:

•Cancer

•Congestive heart failure

•Chronic obstructive pulmonary disease (COPD)

•Kidney failure

•Alzheimer’s disease

•Stroke

•Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig’s disease

•HIV/AIDS

How is palliative care different from hospice care?

It wasn’t until 2006 that palliative care became a board-certified subspecialty of internal medicine in the United States. With only a decade of medical recognition under its belt, palliative care still is misunderstood.

“One of the most difficult aspects to providing care is the common misconception that palliative care is synonymous with hospice care. It’s not,” Goodwin said.

Hospice care is given to patients who no longer are undergoing curative treatment. Palliative care can be given in tandem with curative treatment and regardless of the patient’s medical prognosis. In fact, palliative care often helps patients better tolerate aspects of their treatment regimes, such as the painful side effects of chemotherapy.

Because hospice care and palliative care so often — and incorrectly — are confused, palliative care sometimes is shrouded with an unfair stigma. People who receive palliative care often can be cured of their illnesses and live full lives; palliative care is not indicative of the likelihood a patient will die.

Because of this misconception, patients or their families may not know they’re able to request palliative care, even when it would be helpful.

How do I request palliative care?

In some cases, palliative care is recommended by an attending physician. Often, it is requested by patients themselves. For anyone with a serious, chronic illness, it can be beneficial to talk to your doctor about potential palliative care options.

EXAMPLES of palliative care

Palliative care can be many things, depending on a patient’s needs. Here are some examples.

•A patient with severe heart failure wants to leave the hospital and receive medical attention at home. A palliative care team will work with doctors to determine whether that is possible, what would be required, and what the associated costs would be, then help put the plan in motion.

•A patient’s treatment is making him sick. The palliative care team will help find a medication to ease his nausea and work with a dietitian to create a diet plan that could benefit the patient while he receives treatment.

•A patient who is in intensive care is upset that she has not been able to attend her weekly religious service. The palliative care team will organize a chaplain to hold services for the patient and give her spiritual counseling.

Source: Center to Advance Palliative Care

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