Understanding – and prescribing – palliative care
Woody English, M.D.
Regional medical director, Providence Palliative Care
What is palliative care? It’s a simple question, yet often it elicits the wrong answer, even among clinicians. It’s common to believe that palliative care is for patients nearing the end of life when all other treatment options are exhausted. In truth, its aim is to alleviate suffering in all its forms – physical, emotional, psychological and spiritual – and it can begin as early as diagnosis.
Palliative care allows us to treat the whole patient, to address things that matter beyond the disease. In practice, palliative care involves a team of doctors, nurses, social workers and sometimes nutritionists, physical therapists, pharmacists and chaplains. It can be administered for a range of serious illnesses, including congestive heart failure, emphysema, diabetes, kidney disease and, of course, cancer.
When we give palliative care along with curative care, not only do patients feel better, but their quality of life improves and their anxiety and depression ease.
In fact, a landmark study published in the New England Journal of Medicine in 2010 found that patients given palliative care shortly after diagnosis live longer than those who do not receive such care, and require less aggressive end-of-life care.
The study, “Early Palliative Care for Patients with Metastatic Non-Small-Cell Lung Cancer,” involved 151 patients. Besides having significantly higher quality-of-life measures, patients receiving palliative care lived on average two months longer than patients who received standard care.
Patient story: Home away from hospital »
The reasons for these improved outcomes are still unclear, but the results may be due to better treatment of symptoms or to addressing the patient’s anxiety, depression or stress.
Referrals still too low
Despite this evidence, and the fact that more than 80 percent of health systems provide palliative care services, use of these services by physicians and patients remains low, according to a study published in Annals of Oncology.
Physicians tend to view palliative care as a last-ditch therapy when curative treatments have failed, and many fear that a referral earlier in the process may alarm patients, the study found.
Our challenge is to better integrate palliative care into our patients’ treatment plans.
Providence Home Health Palliative Care works with patients and families on treatment wishes, coordinates care throughout the illness, and helps educate patients and their loved ones on the disease and available resources.
Although these patients suffer a chronic, often terminal disease, palliative care can help them live richer and fuller lives. It’s not just good medicine, it’s our mission as healers.