Palliative care is a specialized type of medical care for people with a life-threatening illness, such as leukemia, lymphoma or myeloma. The goal of this type of medical treatment is to provide patients with relief from symptoms and maximize their quality of life. While it may be used as a complement to cancer treatments intended to cure the disease, it is most often initiated when cure is no longer an option.
Palliative does not mean that you will stop receiving care, but rather the focus of that care will shift from curing your disease to helping you live with it. In fact, palliative care plans may include chemotherapy or radiation therapy if the goal is to provide relief of symptoms, as opposed to curing your cancer.
Palliative care not only aggressively addresses control of the physical symptoms associated with cancer; it also considers other types of suffering, including spiritual dilemmas and social issues, as well as the emotional needs of yourself and your loved ones.
The goals of hospice care are based on the same principles as palliative care. However, while palliative care can begin at any point during your illness, hospice care is initiated at the very end of life, when death is expected within six months. Hospice care is very often provided in the home, on specialized hospital hospice units, or in free-standing hospice facilities.
What are the Principles of Palliative Care?
The basis of palliative care revolves around what the patient determines to be quality of life. When developing a palliative plan, a team of caregivers will help you to meet your care needs while considering your cultural and personal beliefs, relationships, and personal situation.
The principles of palliative care include:
- Death is a natural stage of life
- Care does not speed up or delay death
- Medical procedures and tests are kept to a minimum, unless they are expected to provide relief of your symptoms
- Provides you and your family with skills that will help you to cope with your illness and death
- You know best if pain or other symptoms are being adequately relieved
- Pain and symptom relief medications are dosed to provide you with the best results without unacceptable side effects
- Food and fluids are not forced or artificially provided. If you want to eat or drink, you can
- Helps you to live your life as actively as you want to until your death
- Emphasizes advanced care planning so your wishes continue to be met if you are no longer able to communicate them
Organizing Your Own Palliative Care
Your palliative care plan will change and develop as your disease progresses, but should be driven by goals that you have determined alongside your family and healthcare team. There are a few things to consider when planning the goals of your palliative care:
- What symptoms are you likely to expect at the end of your life? In the case of blood cancers, these may include pain, confusion, bleeding, difficulty breathing, or extreme fatigue.
- What is your prognosis? Are you expected to live for weeks, months, or years with your condition?
- What is important for you to do in the time you have left? Complete a project to pass on to your children? Remain active? Spend time with your family? Explore your own “bucket list?”
- Is there something you feel like you need to do to provide you or your family with “closure?”
- What parts of your life do you want most to preserve?
If you examine these priorities, your team can help to develop your palliative care plan so that these values are upheld.
Summing it Up
Palliative and hospice care are medical specialties that focus more on helping you live comfortably with your cancer than on curing it. While palliative care helps to minimize symptoms and maximize quality of life at any time during your cancer journey, hospice care shares the same goals with a focus on the final weeks and days of life.
The purpose of palliative care is to help you get the most quality out of the time you have remaining before death. The definition of “quality of life” is determined by you and your values and beliefs as opposed to those of your healthcare team or others.
The most important thing to remember about palliative therapy is that nobody is "giving up" and you will always continue to receive care and help from your healthcare team, but the focus of your treatment will be more concerned with helping you feel and cope better rather than on curing your cancer.
Gagliardi, A. “Palliative Care and Hospice “ in Stern, T. and Sekeres, M. (eds). (2004) Facing Cancer: A Complete Guide for People with Cancer, Their Families, and Caregivers. McGraw- Hill: New York. (pp.357-366).
Martinez, J. and Wagner, S. “Hospice and Palliative Care” in Yarbro, C., Frogge, M., Goodman, M., Groenwald, S. (eds). (2000) Cancer Nursing: Principles and Practice 5th Ed Jones and Bartlett: Sudbury, MA. (pp. 1681- 1698).