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Published: June, 2012; Vol 9, Num 1

 

Palliative Care Helps Ensure Quality Medical Treatment

People with serious health problems often require more than medical treatment to help them manage. Palliative care can provide that assistance.

Hospice Care:
Compassionate End-of-Life Treatment

Hospice care is for the terminally ill who are approaching end of life. Unlike traditional medical care where the goal is to preserve life, hospice care acknowledges that death is imminent and focuses on quality of life during that time.

Specially trained health care professionals including doctors, nurses, home health aides, social workers and spiritual counselors assist the family in reducing the patient’s pain and in addressing all other physical and emotional needs.

Hospice care is typically covered by Medicare, Medicaid, the Department of Veterans Affairs and private insurance.

Health care providers and state and local offices on aging can provide information about hospice programs in your community. Information and a directory of providers are also available at the National Hospice and Palliative Care Organization.

"Growing out of the hospice movement, palliative care focuses on quality of life during critical, chronic or life-threatening situations," explains LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni. "In addition to the symptoms of their disease, patients undergoing medical treatment often contend with their therapy's side effects. This is when palliative care can be of benefit."

Alternate description

LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman
Armand E. Sabitoni

It is not unusual to feel sicker during a treatment than before starting it. However, at hospitals and other medical facilities, treatment is the focus, not how it might be making someone feel. With palliative care, specially trained health care professionals including doctors, nurses and social workers as well as pharmacists, nutritionists, massage therapists and chaplains work in conjunction with primary care physicians, helping patients manage symptoms and side effects. For example, while an oncologist is supervising a cancer patient’s chemotherapy, the palliative care specialists focus on relieving the patient’s resulting nausea. If a surgical procedure is necessary, the palliative care team will oversee pain management including side effects like constipation, a common occurrence when taking powerful painkilling narcotics.

Conditions and symptoms that palliative care can help with include:

  • Pain
  • Constipation
  • Nausea and vomiting
  • Diarrhea
  • Bowel or bladder problems
  • Loss of appetite, weight loss
  • Shortness of breath
  • Coughing
  • Depression
  • Confusion
  • Weakness
  • Difficulty sleeping

Resolving symptoms of disease and side effects of therapy helps patients complete treatment and remain active in daily life – going to work, for example – during treatment.

When diseases are chronic or progressive, such as heart disease, AIDS or Alzheimer’s, palliative care specialists can help in planning future medical care. Through ongoing counseling, patients and families are better equipped to make informed decisions. They also have an educated and accessible outlet – during times of serious illness, social contacts sometimes disappear – to discuss fears and concerns.

In helping patients better handle health conditions, palliative care helps control health care costs. A study published in the March 2011 edition of Health Affairs found that Medicaid patients at four New York hospitals who were recipients of palliative care spent less time in intensive care units (ICUs) than other Medicaid patients. If terminally ill, instead of undergoing expensive and oftentimes invasive procedures that would not restore their health, these patients were more likely to spend their final days in hospice care, where comfort – far less costly than medical interventions – is the focus. The study found that Medicaid patients who were recipients of palliative care incurred $7,000 less in admission costs than Medicaid patients who were not.

“With serious health conditions, cures are not always possible. In such cases, the hope is that the condition can be managed and that life can still be fully lived,” says Sabitoni. “With palliative care as a platform, patients and their families are better able to meet this challenge.”

[Janet Lubman Rathner]