Palliative care is specialized medical care focused on providing relief from the symptoms, pain, and stress of a serious illness. The goal of palliative care is to improve quality of life for both the patient and their family by addressing physical, emotional, social, and spiritual needs alongside whatever other medical treatment the patient is receiving.
Unlike hospice care which is reserved for people with a terminal diagnosis and a life expectancy of six months or less palliative care can be provided at any stage of a serious illness and alongside curative or life-prolonging treatment. A person receiving chemotherapy for cancer, dialysis for kidney disease, or aggressive treatment for heart failure can also receive palliative care at the same time.
What palliative care provides
Palliative care is provided by a specialized team of doctors, nurses, social workers, and other specialists who work alongside the patient’s primary care and specialist physicians. The palliative care team focuses on:
- Pain management — assessing and treating pain using medications and other approaches to keep the patient as comfortable as possible
- Symptom management — addressing distressing symptoms such as nausea, fatigue, shortness of breath, anxiety, depression, and appetite changes
- Emotional and psychological support — helping patients and families cope with the emotional burden of serious illness including anxiety, depression, grief, and fear
- Communication and decision support — helping patients and families understand their diagnosis, prognosis, and treatment options and make decisions that align with their values and goals
- Spiritual care — addressing spiritual and existential concerns that often arise during serious illness
- Practical support — helping with practical concerns such as navigating the healthcare system, coordinating care, and accessing community resources
- Family support — supporting family members and caregivers who are affected by their loved one’s illness
Who can benefit from palliative care
Palliative care is appropriate for people of any age with any serious illness including:
- Cancer
- Heart disease and heart failure
- Chronic obstructive pulmonary disease — COPD
- Kidney disease and kidney failure
- Liver disease
- Alzheimer’s disease and other forms of dementia
- ALS and other neurological conditions
- Stroke
- HIV and AIDS
- Serious injuries
Palliative care is not limited to people who are dying. Many people receive palliative care for years while also pursuing curative treatment. The focus is on quality of life at every stage of illness.
Palliative care vs hospice care
Palliative care and hospice care are related but distinct:
- Palliative care — can be provided at any stage of a serious illness alongside curative or life-prolonging treatment. Does not require a terminal diagnosis or a decision to stop curative treatment.
- Hospice care — a specific type of palliative care for people with a terminal illness and a life expectancy of six months or less who have chosen to focus on comfort rather than curative treatment. Requires giving up Medicare coverage for curative treatment of the terminal illness.
In other words hospice is a subset of palliative care. All hospice care is palliative in nature but palliative care is available much earlier in the course of illness and does not require the same eligibility criteria as hospice.
Where palliative care is provided
Palliative care can be provided in a variety of settings including:
- Hospitals — many hospitals have dedicated palliative care teams that see patients during inpatient admissions
- Outpatient clinics — palliative care is increasingly available in outpatient settings for people who are not hospitalized
- Nursing homes and assisted living facilities — palliative care teams may visit residents in long term care settings
- At home — home-based palliative care programs bring palliative care services directly to patients in their homes
Research on palliative care outcomes
A growing body of research supports the benefits of early palliative care integration. Studies have found that people who receive palliative care alongside standard treatment often experience:
- Better control of pain and other symptoms
- Greater satisfaction with their care
- Reduced anxiety and depression
- Clearer understanding of their illness and treatment options
- More care that aligns with their values and preferences
- In some studies longer survival compared to those receiving standard care alone
A landmark 2010 study published in the New England Journal of Medicine found that patients with advanced lung cancer who received early palliative care alongside standard treatment lived nearly three months longer on average than those who received standard care alone — despite receiving less aggressive end-of-life treatment.
How to access palliative care
Palliative care is available at many hospitals and health systems though availability varies by location. Steps to access palliative care include:
- Ask your doctor for a palliative care referral — any physician can refer a patient to palliative care
- Ask the hospital if there is a palliative care team — most major hospitals and many community hospitals now have palliative care programs
- Contact your insurance company to understand your coverage — palliative care is covered by Medicare, Medicaid, and most private insurance plans as part of regular medical care
- Use the Get Palliative Care provider directory at getpalliativecare.org to find palliative care programs in your area
Palliative care and advance care planning
Palliative care teams play an important role in advance care planning — the process of clarifying and documenting a patient’s wishes regarding future medical treatment. Palliative care conversations often address questions such as:
- What matters most to you in terms of quality of life?
- What are your goals for treatment?
- What kinds of medical interventions would you want if you could no longer speak for yourself?
- Have you completed an advance directive or healthcare power of attorney?
These conversations can be difficult but they are enormously valuable in ensuring that patients receive care that aligns with their values and wishes.
Key terms to know
- Palliative care — specialized medical care focused on relief from symptoms, pain, and stress of serious illness at any stage
- Hospice care — a specific type of palliative care for people with a terminal illness who have chosen to focus on comfort rather than curative treatment
- Symptom management — the assessment and treatment of distressing symptoms caused by illness or its treatment
- Advance care planning — the process of clarifying and documenting wishes regarding future medical treatment
- Interdisciplinary team — the group of healthcare professionals who work together to provide palliative care
- Quality of life — a person’s overall wellbeing including physical, emotional, social, and spiritual dimensions
Sources
- National Hospice and Palliative Care Organization — nhpco.org
- Get Palliative Care — getpalliativecare.org
- National Institute on Aging
- Centers for Medicare and Medicaid Services
This article is for general informational purposes only and does not constitute legal or medical advice. Consult a licensed healthcare provider for guidance specific to your situation.