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When to Start Considering Palliative Care

 

Quality of life is at the heart of palliative care. Palliative care professionals strive to make day-to-day living more manageable by focusing on symptom management and supportive care.

So, who should consider palliative care? Let’s explore this question and all that palliative care has to offer.

Defining Palliative Care

Palliative care is a medical approach focused on relieving symptoms, pain, and stress from serious illnesses to improve the quality of life you and your family. It addresses physical, emotional, social, and spiritual challenges, providing a holistic support system.

Palliative care teams, comprising specially trained physicians, nurses, and other healthcare professionals, provide personalized care plans. Services include:

  • Pain and symptom management
  • Emotional and psychological support
  • Financial, legal, and insurance assistance
  • Communication and coordination

Read What Does Palliative Care at Home Include for more information.

Who Should Consider Palliative Care?

Palliative care is designed for individuals facing serious, chronic, or life-limiting conditions where the focus shifts toward improving quality of life and managing symptoms rather than solely aiming for a cure.

Palliative care can be integrated at any stage of illness and works alongside other treatments to provide comprehensive support. It’s beneficial for a wide range of illnesses, including but not limited to:

  • Cancer: Patients undergoing cancer treatment often experience pain, fatigue, and emotional distress that palliative care can help manage.
  • Heart disease: Those suffering from advanced heart disease may benefit from symptom management, such as controlling breathlessness, fatigue, and chest pain.
  • Lung disease: Conditions like COPD and advanced lung disease can cause significant breathing difficulties and discomfort, which palliative care can alleviate.
  • Kidney failure: Chronic kidney disease leading to frequent discomfort or complications can be managed with palliative care to improve comfort and quality of life.
  • Neurological conditions: Including ALS, multiple sclerosis, and advanced dementia, palliative care helps manage complex symptoms and supports patients and their families through ongoing changes.

Can You Refer Yourself to Palliative Care?

Yes, you can refer yourself to palliative care. While many referrals to palliative care come from healthcare providers, you or your family can also initiate the process.

If you or a loved one are experiencing significant symptoms, emotional distress, or a decline in daily functioning due to a serious illness, you can discuss palliative care options with your primary care doctor or specialist.

When to Ask for Palliative Care

When Should You Ask for Palliative Care?

Recognizing when palliative care is needed can improve your quality of life if you are dealing with a serious illness. Here are some key indicators.

You have persistent and significant symptoms.

If you are experiencing chronic and severe symptoms that are difficult to manage, you can find significant relief through palliative care.

  • Chronic pain: Persistent pain that is not adequately controlled by current treatments.
  • Breathlessness: Difficulty breathing that impacts daily activities and quality of life.
  • Fatigue: Severe and continuous fatigue that limits the ability to engage in everyday tasks.
  • Other severe symptoms: Symptoms like nausea, vomiting, and sleep disturbances that are not well-managed.

You have difficulty managing your symptoms with your current treatment.

When existing treatments are insufficient to control symptoms effectively, palliative care can provide additional strategies for relief. This approach includes optimizing medication regimens, utilizing non-pharmacologic therapies, and offering holistic support.

You have frequent hospitalizations or ER visits.

Frequent hospital visits can be disruptive and stressful, significantly affecting your quality of life.

Palliative care aims to reduce these episodes by providing better symptom control and ongoing support.

You are experiencing a decline in daily functioning.

A growing need for daily assistance can strain you and your family. Struggling with basic tasks such as bathing, dressing, eating, and mobility may indicate a decline that palliative care can help address to alleviate these challenges.

You are under severe emotional or psychological distress.

Mental health is closely tied to physical health. Serious illnesses often bring about significant emotional and psychological burdens. Palliative care includes mental health support to help you and your family cope with these feelings.

At What Stage Should Palliative Care Be Considered?

Palliative care is beneficial at various stages of a serious illness. It guarantees you receive appropriate support and symptom management throughout your healthcare journey.

Early Stage

Engaging in palliative care early can have significant benefits. From the outset, palliative care teams can work alongside primary healthcare providers to manage initial symptoms and provide emotional and psychological support.

This early intervention helps you understand your illness, make informed decisions about your care, and establish a strong foundation for ongoing symptom management. For example:

  • Cancer patients: From the moment of diagnosis, palliative care can help manage pain, fatigue, and anxiety associated with the disease and its treatments.
  • Chronic heart disease: Early palliative care can address breathlessness, chest pain, and other symptoms, improving overall quality of life.

Mid Stage

As the illness progresses and treatments intensify, managing symptoms may become more challenging. At this mid-stage, palliative care provides critical support by optimizing symptom control and increasing comfort and well-being.

  • Lung disease: As conditions like COPD worsen, palliative care can offer advanced techniques to manage breathlessness and other respiratory symptoms.
  • Neurological conditions: For diseases like ALS or dementia, palliative care helps manage complex symptoms and supports you and your family through ongoing changes.

Late Stage

In the late stages of illness, when curative treatments are no longer effective, the focus often shifts entirely to comfort care.

Palliative care at this stage guarantees that you experience the highest possible quality of life during your remaining time. This includes intensive symptom management, emotional and spiritual support, and end-of-life planning and decision-making assistance.

  • Kidney failure: For patients whose kidney function has significantly declined, palliative care helps manage symptoms like pain, nausea, and fluid retention to maintain comfort.
  • Advanced cancer: When cancer treatments are no longer viable, palliative care focuses on relieving pain and other debilitating symptoms.

Like hospice care, late-stage palliative care focuses on comfort and quality of life when curative treatments are no longer effective. However, hospice care is specifically for patients in the final months of life, whereas late-stage palliative care can support patients who have a longer prognosis.

Read Hospice vs. Palliative Care for more on their differences.

Benefits of Early Palliative Care Intervention

Benefits of Early Palliative Care Intervention

Early integration of palliative care in treating serious illnesses offers numerous benefits that improve overall well-being and quality of life.

Improved Symptom Management

One of the primary advantages of early palliative care intervention is improved symptom management.

  • Enhanced comfort: Palliative care teams develop tailored pain and symptom relief plans to address your needs. This personalized approach ensures that pain, breathlessness, nausea, and fatigue are managed from the start.
  • Proactive approach: By addressing symptoms early, palliative care can prevent them from becoming severe and more difficult to manage later. This proactive approach improves overall health outcomes and a more comfortable daily life.

Better Quality of Life

Palliative care significantly improves your quality of life by supporting your emotional and psychological needs.

  • Emotional and psychological support: Palliative care includes counseling and mental health services to help you cope with the emotional challenges of serious illness. 
  • Facilitating meaningful activities: By managing symptoms effectively, you can engage in meaningful activities and interactions with your loved ones, which increases your emotional and social fulfillment.

Coordinated Care and Support

Another key benefit of early palliative care is the coordination of comprehensive care and support.

  • Integration of healthcare providers: Palliative care teams collaborate with other providers to coordinate all aspects of your care. This integrated approach helps streamline treatments and avoid unnecessary interventions.
  • Reduced stress for you and your caregivers: Streamlined care reduces the administrative and logistical burdens on you and your caregivers, allowing you to focus more on your well-being and less on navigating the healthcare system.

Informed Decision-Making

Early palliative care also empowers you and your family by providing the information and support needed to make informed decisions about your treatment and care.

  • Guidance on treatment options: Palliative care teams provide clear and compassionate guidance on various treatment options, helping you understand different approaches' potential benefits and drawbacks.
  • Advanced care planning: Through advanced care planning, you and your family can make decisions aligned with your values and preferences so care is consistent with your wishes.
  • Support for emotional, social, and spiritual needs: Palliative care addresses physical symptoms and your emotional, social, and spiritual needs. This holistic support fosters a sense of peace and well-being during challenging times.

How to Start the Conversation About Palliative Care

Initiating a discussion about palliative care can be challenging. Still, it is a vital step so that you or your loved one receives the comprehensive support needed during a serious illness.

It's essential to discuss palliative care early rather than waiting until symptoms become unmanageable or a crisis occurs. Early discussions allow for better planning and smoother integration of palliative care services, which can significantly improve your quality of life from the onset of your illness.

Here are some tips and steps to help guide this critical conversation.

Tips for Initiating Discussions with Your Healthcare Providers

Starting the conversation about palliative care with healthcare providers can feel daunting, but these tips will make it easier:

  • Be open and honest: Approach the topic with openness. Express your concerns, symptoms, and the impact of the illness on daily life.
  • Use clear language: Clearly state that you want to learn more about palliative care. It's crucial to be specific about what you are seeking.
  • Prepare in advance: Write down your symptoms, questions, and specific goals or wishes for your care. This preparation helps you cover all the necessary points during your discussion.
  • Seek support: Consider bringing a family member or friend to the appointment for support. They can help advocate for you and remember details from the conversation.

Questions to Ask During Consultations

During consultations with your healthcare provider, asking the right questions can help you better understand palliative care and how it can benefit you or your loved one. Here are some key questions:

  • What palliative care services are available? How can they help manage my symptoms?
  • How will palliative care be integrated into my current treatment plan?
  • Who will be part of the palliative care team, and what roles will they play?
  • What should I expect regarding changes in my care routine or medications?
  • How often will I meet with the palliative care team, and where will these meetings occur?

Understanding the Palliative Care Process

Understanding what to expect from palliative care can alleviate anxieties and help you navigate the process more confidently:

  • Comprehensive assessment: The palliative care team will thoroughly assess your physical, emotional, and social needs.
  • Personalized care plan: The team will develop a customized care plan tailored to your needs and preferences based on the assessment.
  • Ongoing support: Palliative care involves regular follow-ups and adjustments to your care plan as needed, ensuring continuous support and symptom management.
  • Coordination with other treatments: Palliative care complements other treatments, providing an integrated approach to managing illness.

The Right Time for Palliative Care

Early integration of palliative care can improve symptom management, reduce hospitalizations, and support better decision-making, allowing you to focus on what matters most. If you or a loved one is experiencing persistent symptoms, frequent hospital visits, or a decline in daily functioning, it’s time to consider palliative care.

At Keystone Health, we are committed to providing comprehensive palliative care services tailored to your unique needs. Our dedicated team is here to support you through every stage of your healthcare journey.

If you believe palliative care might be right for you or your loved one, don’t hesitate to reach out and start the conversation.

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