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Palliative Care: A Dignified Solution

Recovering from a serious illness, or learning to live with a chronic condition,  is often a long, slow process.  We rarely move steadily forward, gaining strength and confidence with each passing day; more often that not, there are okay days, bad days, very bad days, and then, every once in a while, a pretty  good day or two.We struggle with depression, denial, pain and anxiety, or watch a friend or loved one go through these familiar but still very difficult transitions, fighting off loneliness, fear and even anger.

There is help, however.  Palliative care, as we discussed yesterday, is specialized medical care for individuals – and their families – who are battling serious and chronic illnesses, illnesses such as cancer, COPD, Alzheimer’s, congestive heart failure, kidney disease and so on.  A team of doctors, nurses and other health care specialists work together with a patient’s regular doctors to provide much-needed extra support.  Chronic diseases bring with them a whole host of exhausting symptoms: pain, nausea, fatigue, shortness of breath, loss of appetite and difficulty sleeping, to name just a few.  Palliative care helps with all of these challenges, boosting the strength and morale of patients so they can manage their medical treatments better and enjoy some quality of life.

Think of palliative care as a partnership: patient, family, medical team.  And the medical team will include palliative care doctors, social workers and nurses, along with chaplains, pharmacists, massage therapists, nutritionists and others, all dedicated to easing suffering and controlling symptoms.

Yesterday, we went over some of the basic questions about who benefits from this care and how to ask for a referral, if necessary.  Below are some further points about how a palliative care program works.

Just what does palliative care involve?

  • Pain and symptom control.  First, the palliative care team will work with a patient (and the family members) to sort out the sources of his or her discomfort and pain.  They will then provide the best treatments that can bring relief.  The problems a patient might be facing include difficulty breathing, depression, insomnia, fatigue, and/or bowel or bladder issues.  The relief includes medication, relaxation techniques, massage therapy and so on.
  • Emotional support.  Unlike so many other medical treatments, palliative care addresses the entire person, not just the illness or that part of a person who is sick.  The team members are alert to all aspects of the healing process and will see to a patient’s psychological, social, emotional and spiritual needs.
  • Communication and coordination.  This is a huge help. We have all experienced the communication gaps between and among our doctors!  Palliative care teams are skilled and trained communicators.  They help establish goals for a patient’s care and work to coordinate all the caregivers and decision-makers.  They particularly stress (and facilitate) keeping open regular lines of communication between a patient, his or her family, and the doctors.
  • Caregiver and family support.  Caring for a chronically or seriously ill family member or loved one takes a great toll on caregivers.  Palliative care teams support those helping their patients, suggesting ways to relieve the stress and fatigue such a responsibility inevitably brings.  They will also help with decision-making if necessary.
What can one expect from palliative care?
  • Symptom relief.  Palliative care looks at the whole person.  The aim is to help the patient enjoy, as best as he or she can, carrying on with daily life.  The approach often makes the rigors of treatment more bearable.  It helps a patient understand his or her medical condition and treatment options.  There is most certainly relief from such symptoms as pain, nausea, constipation, insomnia, shortness of breath and so on.  A real quality of life is maintained and supported.
  • More control over care.  This is very important.  Many patients are embarrassed and even ashamed of their conditions and the helplessness chronic illness can sometimes mean.  They may even  feel as if they are treated as children or worse – are invisible behind the medical tubes and monitors and medications they now require.  Palliative care addresses this.  It provides a calm and supportive atmosphere, helping  patients retain some control over what happens to them, minimizing anxiety and stress.  They help make sure that the patient and his or her doctor continue to communicate regularly.  The treatment plan is reviewed each day and discussed with the patient, whose needs, goals and wishes are respected.  
Okay, then.  All we need now is a good glossary of terms – and that’s for tomorrow.
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