Palliative care is designed to help people who have a serious illness. The illness may chronic (ongoing) or life-threatening. This includes a form of cancer that is not curable. Palliative care helps these people have the best possible quality of life in their final stage. The focus of palliative care is not on dying or trying to find a cure. The focus is on treating the whole person to improve their remaining life.
The main goals of palliative care are:
- To relieve pain and other symptoms.
- To help improve emotional, mental, and spiritual well being.
- To support the family members of the person is ill.
Palliative care involves a partnership between the person who is ill, his or her family and friends, and the health care team. This team may include a doctor, nurse, social worker, counselor, and spiritual advisor.
Palliative care is different from hospice care. Hospice care begins when treatment has stopped and the patient will not survive. The patient will be made as comfortable as possible through the end of his or her life. The individual and his or her family also will receive emotional and practical support as they prepare for death.
Path to well being
Palliative care can occur at home or in a hospital or hospice facility. The person who is ill and their family should decide which option is best. Before making this choice, you should learn about the pros and cons of each care setting. It can be helpful to talk with a doctor or other members of the health care team. It may be possible to receive care at home for a while and then move into a hospital or hospice facility as the illness progresses. If a person prefers to receive care at home, ask the doctor for information on local support programs. For example, some programs offer the services of respite care workers. These workers manage the person’s care for a few hours each day to give the primary caregivers a break.
As a person’s illness advances, he or she may have a number of symptoms. These can include:
- pain
- loss of appetite
- fatigue
- weakness
- weight loss
- constipation
- trouble breathing
- confusion
- nausea
- vomiting
- cough
- a dry or sore throat
These symptoms can be managed with treatment. A person who is sick should not try to “be strong” and tolerate pain or other symptoms. This can have a negative effect on their physical and emotional state. They should tell their care team about any symptoms they have.
Pain is one of the most common symptoms of someone who is dying. Even severe pain can be controlled with medicine. Each person responds to pain differently. The doctor will create a pain management plan that meets the person’s needs. Pain medicines can be given by mouth (liquid or pill) or in the rectum (suppository). They also can be given through the skin with an injection or a transdermal patch. Chronic pain needs to be treated on a regular schedule. It is important to give doses on time. Do not to wait until the person feels pain before giving the next dose, even if this means waking them up. This can delay the effects of the pain medicine.
For some people, the doctor may prescribe an opioid medicine to relieve pain. Examples include morphine and codeine. Opioids often cause constipation. The person may need to take another medicine to counter this common side effect. The person in pain may be worried about getting “hooked” on an opioid. However, addiction to pain medicine at this stage in life is very rare.
It may take time for the doctor to find the most effective way to manage pain. Try not to feel discouraged if a certain approach doesn’t work. The person must tell the doctor if they have preferences for pain treatment. This can help the person who is ill feel more in control and at ease.
Things to consider
People face the end of life in their own way. It’s normal to feel everything from disbelief and anger to acceptance. People may struggle with regret for the way they’ve lived or things they’ve done. They may worry about being a burden on their family. They may stress about how their family will manage without them. These feelings and fears are normal. However, they can negatively affect a person’s quality of life if they aren’t dealt with.
Palliative care offers the chance to find peace of mind by facing feelings and beliefs about life and death. Each person must find meaning and peace in their own way. Some people find comfort in talking about their feelings. This could be with a close friend, family member, spiritual advisor, counselor, or support group. Others may prefer to deal with their emotions on their own. They may enjoy writing in a journal, painting, praying, or listening to music.
Making arrangements for death can be a very hard process. Palliative care can help with this. Dealing with these matters in advance can reduce the family’s burden after the person’s death. Financial, legal, and emotional problems are common things family has to deal with. It also gives the person who is sick a chance to weigh on decisions. For example, preparing a will allows them to choose what happens to their belongings. It helps to organize records, documents, and instructions that family will need after death. The person who is dying may have certain wishes regarding a funeral or memorial service. These choices can be a personal reflection of the person’s life and how they want to be remembered.
As the death of a loved one grows near, each family member reacts differently. It is common to have a range of emotions, such as anger, worry, and helplessness. There is no single right way to deal with this situation. Family members should try to accept one another’s responses and feelings. Also, they should keep in mind that emotions don’t follow a time schedule. Just because one person is ready to move on to the next stage of grieving doesn’t mean everyone else is. Palliative care can help family members make the most of their time with their loved one. This is more important and healthy than focusing on their death.
Questions to ask your doctor
- How do I know if I am or my ill family member is ready for palliative care?
- Where do you recommend palliative care occur?
- Who will be a part of my palliative care team?
- What should my pain management plan include?
- What other types of treatment and services are included in palliative care?
- How much does palliative care cost and does my health insurance cover it?
Resources
National Institute on Aging: What Are Palliative Care and Hospice Care?
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This article was contributed by familydoctor.org editorial staff.
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
