How palliative care works

Created date

January 24th, 2020
Erickson Living Chief Medical Officer Matt Narratt, M.D., met with people moving to Windsor Run.

In this column, we will review pain and symptom management in the setting of progressive or life-threatening illness. 

In addition to pain, progressive illness is commonly associated with a multitude of symptoms, ranging from fatigue to nausea to shortness of breath. To best manage all the emotional and physical challenges of serious illness, it is best to take a comprehensive approach. This approach should consider the patient’s needs and preferences in the context of their goals and should include coordination of care among all providers across all sites of care. 

The recognized medical specialty that takes this holistic approach is known as palliative care and includes care of the terminally ill as well as individuals with advanced illness. The goals of palliative care are to manage symptoms, improve quality of life, maximize daily functioning, and ease the mental strain of being seriously ill. A patient can be pursuing a cure or aggressive treatment for their condition while still receiving palliative measures. It is different than hospice where aggressive care is typically withdrawn in the setting of terminal illness. 

Almost anyone living with a serious illness, such as heart failure, cancer, dementia, or Parkinson’s disease, may benefit from palliative care. It can be helpful at any stage of illness, but is generally most effective if initiated earlier rather than later. Early intervention provides the time to do a complete palliative care assessment and review the many options available. Unlike a standard assessment, palliative care evaluations consider not just the medical history but also the emotional, social, and spiritual domains, and the importance of family and coordination of care. 

Effective in managing symptoms

With such a comprehensive approach, it is no surprise that research shows that palliative care programs are effective in helping patients manage symptoms and maximize their functioning. They often result in substantial improvements in health and well-being, and in some studies, patients in palliative care have lived longer than those receiving standard care for the same condition. 

While the palliative care approach seems ideal for the management of any illness, it is most relevant to more serious life-threatening conditions, as it requires substantial investments in time and effort. That being said, it is important to consider the universal aspects of palliative care such as recognizing someone’s needs and preferences as they manage through an illness. It is also important to recognize when it is time to initiate palliative care. For example, someone can have a chronic illness for years, such as heart failure, and live fairly independently, but then the disease progresses and there comes a time when relieving pain and dealing with the emotional, spiritual, and other aspects of life become a priority.

Palliative care is a valuable option that is underutilized and often misunderstood to just be relevant to terminal illness. That is simply not the case. If you are managing the many challenges of a progressive or life-threatening illness, please speak with your primary health care provider about whether you could benefit from a palliative care approach or consultation. It may empower and sustain you through a most difficult time.

In good health,

Dr. Narrett