CONDITIONS

What Is Palliative Care

Palliative care is a type of medical treatment for people with serious illnesses. You can receive palliative care at home, or in a hospice or hospital setting. It can be given with treatments for your disease, or you can ask for palliative care alone if your illness is incurable or you feel the treatment is worse than the disease. Palliative care can also help to relieve the side effects of other medications you take. Palliative care is often provided by a team of health care providers, including doctors, nurses, and other specialists.

Palliative care helps to relive unpleasant symptoms such as:

  • Pain
  • Fatigue
  • Constipation
  • Trouble breathing
  • Sleep problems
  • Nausea/loss of appetite
  • Depression

About 90 million Americans have serious or life-threatening illnesses. This number may climb to nearly 160 million by 2020. According to the Center to Advance Palliative Care, 6 million Americans could benefit from palliative treatment. 3[CAPS/Stats/p1/bull1-3] Yet 7 out of 10 people don’t know anything about it. And among those whom do, many think palliative care is just for people who are dying, a type of care better described by the services offered by hospice. In fact, palliative care is also appropriate for people with a long life ahead of them, and for all ages, including children, the elderly, and anyone in between.

Symptoms of Palliative Care

Palliative care can treat a wide range of disease symptoms and medication side effects. If a symptom is bothering you, talk to your doctor. Some of the symptoms that are often treated with palliative care include:

  • Pain
  • Fatigue
  • Constipation
  • Trouble breathing
  • Sleep problems
  • Nausea/loss of appetite
  • Depression

This is not a complete list. Different people have different views of what makes a good life and what symptoms can get in the way. If you have a disease symptom that’s bothering you, talk with your doctor, regardless whether you see your symptom listed here.

Prognosis

Palliative care can be vital for many people, including some who have a long-term illness, others with a curable disease, and still others who have only a short time left to live. Your prognosis depends on your medical condition.

Whether you have a short-term illness or a chronic condition that requires long-term management, the purpose of palliative care is to help you make the most of the time you have. All the same, there is some evidence that palliative care may also help you live a little longer. A study in 2010 found that people with lung cancer survived almost 3 months longer if they got palliative care from the start.

Palliative Care Can Help You Get the Most Out of Life

Good palliative care isn’t just about treating symptoms; the point is to help you get the most out of life. This works best if you speak with your medical team about your goals for treatment and for life, including:

  • What matters most to your quality of life
  • Whether you have a living will
  • Any religious or personal beliefs that may affect your treatment

There are also steps you can take to help yourself if you have almost any serious or long-term illness, including:

  • Learn all you can about your condition
  • Take care of your health; eat right and stay active
  • Talk openly with your loved ones
  • Ask for help when you need it from your doctors or from family and friends
  • If you feel depressed, seek help

Who Would Benefit from Palliative Care?

According to the Center to Advance Palliative Care, more than 6 million Americans could benefit from palliative care. A number of questionnaires are available to your doctor to help screen you for palliative care needs, based on factors such as:

  • Pain and other symptoms
  • Your psychological wellbeing
  • How well you manage day-to-day functions
  • Your quality of life

Other screening tools can help measure the burden on you if you are struggling to care for a loved one with serious illness.

Unfortunately, not all doctors will think to screen you. If your symptoms are making you suffer, ask for help.

Preventive Palliative Care

Many doctors think of palliative are as something that becomes an issue after someone is already suffering. However, some doctors and health organizations have begun to talk about preventive palliative care. Preventive palliative care refers to:

  • Screening to recognize and treat symptoms early on
  • Help with long-term health care planning, so that people can arrange plans for their future health care

At this time, preventive palliative care is a fairly new concept, and it has not been worked into all of our health care institutions. But some doctors and health advocates have been working to make it a reality.

Medication And Treatment

Palliative care includes a number of medicines to treat a range of symptoms.

Medicines used to treat pain include:

  • Acetaminophen (Tylenol), which offers mild pain relief without upsetting your stomach, but taking too much, for too long, may damage your liver.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) and naproxen (Aleve), which give stronger relief but may cause stomach troubles with long-term use. NSAIDs are also available in prescription strength.
  • Celecoxib (Celebrex), a prescription COX-2 inhibitor, which does not affect your stomach, but can increase your risk of heart attack.
  • Opiates (narcotics) such as morphine. Opiates are available by prescription only. They offer powerful pain relief but can cause addiction or dependence. Narcotics may also cause constipation or make it hard to think clearly.

Medications to treat depression include:

  • Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft)
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) and duloxetine (Cymbalta)
  • Tricyclic antidepressants such as amitriptyline (Elavil) and nortriptyline (Pamelor)
  • Other antidepressants, such as bupropion (Wellbutrin)

Other medicines used in palliative care include:

  • Dexamethasone (Decadron) to treat fatigue
  • Anti-seizure medicines like carbamazepine (Tegretol, Equetro) and diazepam (Valium), which may also help with pain or anxiety.
  • Docusate sodium for constipation or loperamide (Imodium) for diarrhea
  • Metoclopramide (Reglan) to treat nausea and vomiting

Complementary and Alternative Treatment

Complementary and alternative medicine often play an important role in palliative care. Many alternative therapies seem to be effective at relieving pain, reducing stress, and improving quality of life. Some treatments that may be helpful include:

  • Acupuncture or acupressure
  • Relaxation techniques, such as meditation, yoga, and music or aromatherapy
  • Biofeedback
  • Massage
  • Chiropractic

When To Contact A Doctor

If your doctor is treating you for a serious illness and pain or other symptoms are bothering you, tell your doctor. Palliative care may help you live a better and more comfortable life.

Questions For A Doctor

When you go to see your doctor, it’s good to have a list of the questions you’d like to have answered. Take a moment to write down some of the things you want to know. Your questions for your doctor might include some of these:

•    Do you recommend palliative care for me?
•    What are my treatment options?
•    What are the side effects?
•    Does my insurance cover this treatment?
•    How closely do you coordinate with other members of my palliative care team?
•    Is there anything else I should know about palliative care?