Medical | November 12, 2018
This Palliative Care Awareness Month, Kristina M. Conner MD, Director of Palliative and Supportive Care at Lawrence General Hospital, sat down with DynaMed Plus editors to discuss end-of-life care.
Palliative care is a medical discipline aimed at improving quality-of-life for patients with serious, life-limiting disorders. As a relatively young medical specialty, some physicians may not fully appreciate the role a palliative care team can play in patient care. Here are five things palliative care physician Dr. Kristina M. Conner, MD wishes all physicians knew about palliative care.
While all hospice care is palliative, a common misconception is that hospice and palliative care are synonymous. Palliative care, which aims to improve quality-of-life for patients with serious, life-limiting illness, can (and should) be provided along with curative therapy. In contrast, hospice care is a specific form of palliative care that is provided when the focus has shifted from providing disease-directed treatment towards care exclusively focused on managing symptoms.
It is desirable to integrate palliative care into multidisciplinary care for patients with serious, life-limiting disorders at any age and any stage of illness. Ideally, clinicians should discuss patient goals and preferences while the patient is able to fully participate in the discussion and should include a palliative care clinician or team in this discussion, if possible. Better outcomes are observed with early integration of palliative care, and involving palliative care at the time of diagnosis for patients with advanced cancer is now considered standard of care by the American Society of Clinical Oncology (ASCO).
The goals of palliative care align with goals of other specialties—that is, relief of pain and suffering caused by disease.
Palliative care can be provided at the same time as other types of disease-directed care, such as curative treatment. Because the goals of palliative care align with goals of other specialties—that is, relief of pain and suffering caused by disease—palliative care should be considered a part of collaborative care. Rather than thinking that initiating palliative care is giving up on a patient, specialists should consider how a palliative care physician can help them better understand the goals and preferences of their patients.
Sometimes during a long-fought illness, patients and physicians get into a cycle where the physician feels the need to treat and the patient goes along to avoid disappointing them. The result can be unnecessary, aggressive therapy that diminishes quality-of-life. In these cases, a palliative care physician may be able to help the patient better define their goals, which may involve stopping disease-directed therapy.
For every patient with a serious, life-limiting disease, a point is inevitably reached when there are no more options for a cure, but that doesn’t mean that members of the care team are done. As a physician, you have entered a doctor-patient relationship not to treat a disease, but to care for someone suffering. Consideration and respect for your patient and their experience might just be what they need at this time.
For more information on palliative care including care planning and care models, explore the Palliative Medicine topics courtesy of DynaMed Plus® - the next-generation clinical information resource designed to decrease time to answer.
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