If you’ve never heard of palliative care, you’re not alone. In
a recent survey
, only 24 percent of people said they were familiar with the term. Palliative care isn’t nearly as well known as, say, hospice care; in fact, people often confuse the two. Its use is growing fast, however, and
59 percent of hospitals
with more than 50 beds now have palliative-care programs.
this type of care because it appears to be
cost-effective and may improve
health outcomes. Patients — once they know about it — like it because it can make them feel better.
The goal of palliative care is simple: Improve the quality of life for people who are dealing with serious chronic or life-threatening medical problems. People with diseases such as cancer, congestive heart failure, HIV/AIDS and kidney failure often have tremendous problems with pain, shortness of breath, fatigue and nausea, among other symptoms. Especially in a busy hospital, it’s challenging to keep these patients comfortable and pain-free and to help them deal with the difficult medical and personal decisions they may face. That’s where palliative care comes in.
Specially trained palliative-care teams, which typically include a doctor, a nurse, a social worker and a spiritual counselor, focus on relieving pain and managing symptoms. They coordinate a patient’s care among different providers, if necessary, and help patients and their families determine care goals and make treatment decisions. If a patient is nearing death, the palliative-care team can offer emotional and spiritual support.
Palliative care — from the Latin “palliare,” which means “to cloak” — grew out of the hospice movement that began in the 1970s. “We showed that you don’t have to die in pain,” recalls Michael Levy, director of the pain and palliative-care program at Fox Chase Cancer Center in Philadelphia. “You can have more comfort and function, and attend to the anticipatory grief work that helps the patient and the family.”
As hospice care became more established, policymakers and clinicians realized that seriously ill patients, even when not facing death, could benefit from better pain and symptom management and other palliative-care services. Today, hospice care is at one end of the spectrum of palliative care. But while hospice is generally offered to people who are expected to live six months or less, palliative care can be provided in conjunction with curative treatments. Many patients who receive it aren’t expected to die anytime soon.
After Andre Chervin began a series of radiation sessions in 2008 to treat a cancerous mass in his throat, he caught a virus that causes severe diarrhea and was admitted to Mount Sinai Medical Center in New York for a week. While there, Chervin was in extreme discomfort because the radiation treatments had dried up his saliva, making his mouth and throat so dry that he couldn’t swallow.
“It was horrible,” says Chervin, now 83. “You cannot eat; you can only drink.”
The palliative care team visited him and set him up with a spray bottle that contained artificial saliva that he could spray into his throat. The liquid didn’t taste pleasant, but at least it allowed him to swallow.