Navigating the complex American health-care system can be challenging, especially if you are facing a severe illness.
Many patients do not always know about their options for care. While advances in medical technology enhance prognosis for many common and serious illnesses, other advances in the way care is provided have been shown to improve quality of life.
One such example is palliative care, which refers to medical care intended to relieve suffering for those with a serious illness.
Palliative care to prevent and relieve suffering is often provided in the context of potentially life-sustaining or curative treatments such as chemotherapy for cancer. The two types of care are not mutually exclusive and can be readily coordinated.
One of the important general aspects of palliative care is its breadth. Services are multidisciplinary and address physical, mental, psychosocial, economic and even spiritual aspects of disease burden and suffering. It recognizes the many challenges facing both patients and their families in the context of their illness.
Palliative care also spans both the spectrum of illness severity and the breadth of treatment scenarios.
Palliative care is not synonymous with end-of-life care. It can be introduced at the earliest stage of disease diagnosis and span treatment during all phases of disease up to and including the terminal stage of disease, death and even services for a grieving family and caregivers after death. Moreover, palliative care does not require a diagnosis of terminal illness.
Palliative care can be provided in the hospital, clinic, nursing home and even in the home. (Yes, some doctors still make house calls.)
There is often confusion about the difference between palliative care and hospice. Hospice refers to comfort-focused measures for people with a terminal illness. Typically, people receiving hospice are not pursuing life-sustaining or life-prolonging treatments. Hospice is a form of palliative care provided at the end of life. Yet palliative care also can be provided in the earlier stages of illness and even coincident with life-sustaining treatment.
While commonly discussed in terms of cancer, palliative care is appropriate to many other disease states including to name just a few congestive heart failure, chronic lung disease and dementia.
Palliative care addresses one of the core philosophies of health care. As one sage has put it, the health-care professional strives to heal sometimes and to comfort always. Healing and the alleviation of suffering should be and can be complementary.
The role of palliative care is on the rise. Specialty training and certification exists for medical practitioners of palliative care who devote their professional work to this purpose. Many communities, including our own, are now the benefactors of this important expertise.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Health Center in Towaoc.