Palliative Care

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• QWhat is palliative care?

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  A Marianne Biangone , Nursing, answered on behalf of Sigma Nursing

  Palliative care is specialized care for individuals with serious illnesses. It is focused on providing patients with relief from the symptoms, pain, and stresses of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both the patient and the family.

  Palliative care is provided by a team of doctors, nurses, and other specialists who work together with a patient's other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

  Palliative care treats people suffering from serious and chronic illnesses including cancer, cardiac disease such as Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), kidney failure, Alzheimer's, HIV/AIDS and Amyotrophic Lateral Sclerosis (ALS). Palliative care relieves the symptoms of these diseases.

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• QHow many people have discussed end-of-life care with a doctor?

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  A Baptist Health South Florida answered

  About nine in 10 (89 percent) Americans believe they should talk about end-of-life treatment options with a doctor. However, only 17 percent say they've actually had such a discussion, including 27 percent of people over the age of 65, according to a poll conducted by the Kaiser Family Foundation.

• QWhat is comfort care?

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  A Dr. William D. Knopf, MD , Cardiology (Cardiovascular Disease), answered on behalf of Piedmont Heart Institute

  Comfort care is a term for the care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of comfort care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called supportive care and symptom management.

  This answer is based upon source information from the National Cancer Institute.

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• QHow can I prepare for palliative care?

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  A UCLA Health answered

  There are a few practical steps you can take to prepare for palliative care.

  • Complete an advance healthcare directive, a legal document in which you make your medical wishes known, and identify a surrogate decision maker, also called an agent, to help communicate your medical wishes.
  • Discuss your medical wishes with this person and other close family and friends, as well as your doctor.
  • Keep copies of your advance directive at home and with your agent, doctor and local hospital.

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• QWhat kinds of services can a palliative-care team provide?

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  A UCLA Health answered

  Teams typically include physicians and nurses as well as chaplains, social workers and other allied professionals on an as-needed basis. In terms of what they address, certainly pain is a very common symptom and an important part of palliative care, but not everyone, even at the end stage of a disease, has pain. From the physical perspective, palliative-care teams also manage fatigue, nausea, constipation, dehydration, non-healing skin sores, shortness of breath and dry mouth, to name a few.

  It’s not just physical symptoms, though. There is also anxiety, depression and confusion. We manage psychological distress, which can simply mean providing assistance in coping with the stresses and demands of the situation. And palliative care also addresses existential or spiritual distress—whatever, for the individual, it means to be facing off with his or her mortality.

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• QHow can a social worker help provide palliative care?

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  A Dr. Audrey K. Chun, MD , Geriatric Medicine, answered on behalf of The Mount Sinai Health System

  Social workers are a valuable source for information on hospital and community resources. Working with your care team, a social worker can offer guidance on entitlements and advance directives, as well as on managing stress associated with caring for family members. They can also refer to and coordinate additional support services.

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• QWhat is pediatric palliative care?

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  A Dr. Daniel R. Spogen, MD , Family Medicine, answered on behalf of Univ. of Nev. School of Medicine, Family Medicine

  Pediatric palliative care is care with the goal of maintaining or improving a child's quality of life. Pediatric palliative care achieves this by adequately controlling pain and other symptoms that come from the child's treatments.

• QHow can palliative care help my loved one?

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  A Dr. Daniel R. Spogen, MD , Family Medicine, answered on behalf of Univ. of Nev. School of Medicine, Family Medicine

  Palliative care can help your loved one by improving his or her quality of life by making him or her comfortable. Palliative care is medicine with a different perspective. The goal of palliative care is to improve quality of life by controlling pain from disease processes as well as treatments including chemotherapy.

• QWhen should someone seek palliative care for a loved one?

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  A Dr. Daniel R. Spogen, MD , Family Medicine, answered on behalf of Univ. of Nev. School of Medicine, Family Medicine

  People should seek palliative care for a loved one when doctors believe that a curative therapy course will do more harm than good. This is usually encountered when the person has a terminal process with a low chance of cure.

• QWhat questions should I ask about hospice if I have terminal cancer?

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  A PearlPoint Cancer Support answered

  If you have terminal cancer, you may want to consider asking your healthcare team the following questions about hospice:

  • Should I consider hospice care now or in the near future?
  • Will insurance cover my hospice care?
  • If my life expectancy is longer than six months, can I still get hospice care?
  • Can I get hospice care in my home?
  • Who will be caring for me? Will they be doctors, nurses, social workers or home-health aides?
  • What legal issues such as advanced directives, living wills or medical power of attorney should I think about?