#cancer hospice care
The Basics of Palliative Care
Stacy Fischer, MD
by Stacy Fischer, MD
Associate Professor of Medicine, University of Colorado of Medicine
Most of us will experience a time living with an advanced serious illness. For persons with cancer, this time can lead to an incredible emotional and financial strain for themselves and their caregivers. Health care has grown increasingly costly, fragmented, and the focus is often on all else but the patient.
Palliative care is a medical specialty that may address the unique needs and challenges faced by patients with advanced serious illness, like cancer. Palliative care is often delivered by an interdisciplinary team composed of doctors, nurses, social workers, and chaplains.
The focus is on pain and symptom management, maximizing quality of life, and improving communication between patients and their care providers by helping to match patients’ goals with the medical care possible.
Palliative care can be given concurrently with chemotherapy, surgery, radiation therapy, or other life prolonging treatments.
Palliative Care vs Hospice Care
One common barrier to patients accepting palliative care is the mistake of equating palliative care with hospice care.
In hospice care, all the treatments are directed toward comfort and patients rarely receive life prolonging therapies. Hospice is offered within the last 6 months of life.
In contrast, palliative care can be offered at the time of diagnosis of a life-limiting illness, even when patients may be expected to live years. In fact, early palliative care for advanced lung cancer helped improve patients’ quality of life, symptom burden, and actually helped patients live longer. More studies examining the benefits of early palliative care interventions are ongoing but evidence to date suggests that palliative care helps people live better.
So to address some of the questions and concerns about palliative care, I have added a few commonly asked questions with answers.
Is palliative care the same as hospice care?
See the section above palliative care is not hospice.
Where can I get palliative care?
A growing number of hospitals and outpatient cancer centers now have palliative care consultative services. In addition, many hospice programs have expanded to include separate community-based palliative care programs. Ask your provider or social worker what might be available at your health care center or in your community.
It is also important to remember that a palliative approach can be incorporated by your own primary care provider or oncologist. Here are some of the core things you might want to talk about with your oncology care provider:
- Pain or other symptoms such as constipation, nausea, anxiety, depression, and fatigue
- Prognosis-what kind of information do you want to know about your prognosis?
- Advance Care Planning-having your health care providers lead you through a discussion or consider a more DIY start through patient-centered websites such as Prepareforyourcare.org
Who pays for palliative care?
Nearly all public and private insurances including Medicare or Medicaid will cover inpatient consultation. Most will also cover community based palliative care services.
Palliative care is increasingly recognized as a mainstream part of comprehensive cancer care. The American Society of Clinical Oncology, American Cancer Society, National Comprehensive Cancer Network, and the Institute of Medicine have all endorsed palliative care as part of quality cancer care. If you would like to find out more about palliative care check out this website .
I had no idea that palliative care even existed until very recently when I had a friend who requested it. I thought it was the same as hospice care. After reading your article, though I know that it can be given at the time of a diagnosis of a life-limiting illness. It s cool that it can actually extend the life of individuals too!
Jeanne Rice says
The article is very informative and helpful in explaining the difference between these two kinds of care.
In the section Is Palliative Care the same as Hospice Care? , it says, Did you even read the above section? When someone says did you even . that kind of jars sensibility and seems very unkind. Possibly you could say that differently. It sounds like you are very annoyed. It makes me wonder how you might treat someone in person.
And, it seems like this subject is ALL ABOUT how you will treat someone in person. How kind and compassionate would you be when you are giving palliative care?
Jeanne, thanks for bringing that to our attention. Top med professionals guest write blogs to inform patients, and we appreciate your feedback on the tone. We ve updated to reflect both our organization s and our guest writer s priority to help patients through a diagnosis.
It looks like palliative care is the way to go. My grandfather used hospice in the months before he passed away, and they re not a bad service. If research is beginning to show that palliative care makes patients more comfortable, though, I m definitely going to look more into it if my parents or I ever need similar services. Thanks Stacy!
It is so good that they have Palliative care. I have an aunt that went through serious cancer and it was difficult on her and her family. I am sure that if she had palliative care her journey would have been much more manageable.
Stacy, for a while I was under the impression that palliative care and hospice care was the same things. I didn t realize that hospice care was only offered withing the last six months of life and palliative care could be offered when a patient is diagnosed with a life limiting illness. I will have to keep that in mind.
It s great to know that we have a lot of options in the case of terminal illnesses. Palliative care can really help to improve the quality of life for many people. In my opinion I think that is even more important than intense chemo-therapy.
Thanks for explaining palliative care so well. A number of close family members in my family are getting increasingly advanced in age, so we re starting to look at the treatment and care options for them and their various health issues. I m glad that you noted that early care may be better; that will probably influence our decision. Thanks for the information.
Thanks for the information! My mother could benefit from palliative care, so I ve been looking for a facility for her. I ve always thought that they re usually privately owned by doctors that offer palliative care, so it s good to know that she can get it in an outpatient cancer center that offers it. I hope that we can find a center near our house where she can get quality palliative care.
Hospice care was the most amazing thing I have ever seen. My grandpa had prostate cancer when he moved in with us, and we weren t able to give him the care he needed, so we got a hospice care for him. Absolutely amazing people, they were fantastic and extremely professional. He had cancer for a few years but didn t really need any care until the last 2 or 3 months of his life, do you think that palliative care would have been a nice thing for him to have?
I had no idea that there was a difference between hospice care and palliative care. I have been researching items for my aging parents, and thankfully, no serious harm has come to them. That doesn t mean I wouldn t want to share this information with other loved ones who actually have family that have suffered or are going through such trials. I will pass this on to them to be able to provide for them.
Katie, glad you found this info helpful! Thanks for the comment!