What is Palliative Care?

As a palliative care provider, I tell my patients that palliative care is NOT just about end of life.  Palliative care is about understanding patient and family goals - what's important to them.  Is it about prolonging life?  At what cost?  Is it about spending quality time with family members?  Is about remaining independent as long as possible?

The other most important piece is making sure the patients have a clear understanding of what their disease is, what their treatment options are and the realistic outcomes to expect from those treatment options.

Once we understand what those goals are, further decisions about invasive treatments becomes very clear.  Sometimes palliative care involves advocating for invasive treatments when it is in alignment with the patient goals of care and the patient understands the outcome.  Other times it is advocating for supporting the patient and family through a natural disease process.

Palliative care is about living with terminal disease.  This means our goal is to mitigate symptoms so that patients are able to get up and around and live their lives, and transition that living with more and more support as their disease progresses - to enhance quality of living.  

Some patients need more palliative care, and this is where we lack resources.  We need more palliative care trained providers to be able to have in-depth conversations about goals and treatments, As more and more people die of complex disease, such as cancer, we need expertise in symptom control. As more and more people live alone or with frail spouses at end of life, we absolutely need more hospices where people can die supported.  Right now there is a frightening lack of resources.

By increasing access to good palliative care, studies show that this saves money.  Fewer people have aggressive (futile) life-prolonging interventions.  More people die at home or in hospices rather than acute care hospitals.  We all die, we will all need to access good palliative care.