Palliative Care May Be the Answer for Patients Not Ready for Hospice

LEXINGTON, Ky. (Nov. 10, 2014) -- Quality of life. It is a term we often hear when someone has a life-threatening illness where treatment and therapies can prolong life but may not allow patients to live a fulfilling or necessarily comfortable life.

Today, people with cancer and other very serious diseases are living longer and survival times that once were measured in weeks are now measured in years. For this reason, palliative care is often the key for many in finding quality and comfort.

Psychologist Elisabeth Kubler-Ross began writing books in the 1960s and 70s on death and dying that have reshaped most of what we know about modern end-of-life care. And in the past decade, hospice care and palliative care services have been in increasing demand for the elderly, terminally or chronically ill.

Still, much about hospice care and palliative care is misunderstood.

What is the Difference in Hospice and Palliative Care?

Hospice care generally provides support and symptom management for patients whose life expectancy is thought to be six months or less. Palliative care is not about death and dying; it is about making the most of life, for however long it lasts and has no time restrictions. Palliative care can be received by patients at any stage of illness, whether it be terminal or not. 

However, hospice and palliative both focus on the word "care." You want the patient to be as comfortable as possible. You want them or their family to have as much control as possible and you want to be able to manage symptoms and pain so the individual and the family can focus on the time together, no matter if it is measured in weeks, months or years.

Who Could Be Helped from Palliative Care?

Some of the serious illnesses where patients may benefit from palliative care include cancer, cardiac disease, respiratory disease, kidney failure, Alzheimer's, HIV/AIDS, amyotrophic lateral sclerosis (ALS), multiple sclerosis and others.

What are the Benefits of Palliative Care?

Regardless of the disease, its stage or prognosis, the focus for the patient is completely on quality of life. That includes pain management and the treatment of symptoms such as shortness of breath, nausea, fatigue, loss of appetite and insomnia. But it also includes making sure the patient's emotional and spiritual needs are fulfilled. The goal of a patient receiving palliative care is to help them carry on with their daily live as much as possible.

Overall, palliative care should be thought of as a component of a comprehensive treatment plan available early on in a patient's disease. Goals of care and therapies are developed for each patient, which can then inform the discussions and decisions about their treatment. This empowers patients, because they are the ones deciding what they want to get out of their medical care and how that will impact their life.

Dr. Gerald Klim is director of the Adult Palliative Care and Hospice Program at UK HealthCare

This column appeared in the Nov. 9, 2014 edition of the Lexington Herald-Leader.