When Should Someone Be Offered Palliative Care?

If you’re familiar with the term “palliative care,” you may think it is only used when patients are near end-of-life. While it is true that palliative care helps patients in the later stages of their illnesses, the use of palliative care also makes life better for patients at all stages of their journey.

 “Our specialty takes care of people who have serious, life-threatening illnesses, such as cancer, heart failure, kidney failure and others,” says Anil Desai, M.D., palliative care provider at Hackensack University Medical Center. “We’re here to improve quality of life and to manage symptoms throughout the entire journey the patient is on, not just in the final stages of that journey.”

What Is Palliative Care?

Dr. Desai explains that people often think of palliative care as pain management, but it goes far beyond that. “Palliative care is a specialty focused on people living with a serious illness that is affecting their quality of life,” he says. “The goal is to improve quality of life, and we do that by managing symptoms.”

That includes both physical and emotional problems such as: 

• Pain
• Nausea
• Shortness of breath 
• Loss of appetite
• Anxiety
• Depression 

“We look at the person as a whole and try to mitigate all of these factors to improve their day-to-day living with a serious illness,” Dr. Desai says.

 Because of its holistic nature, palliative care is a multidisciplinary practice that involves providers from many departments. Beyond oncologists and cardiologists who primarily take care of the patient, Dr. Desai works with social workers and psychotherapists. “We also incorporate spirituality, so we work with the chaplains as well,” he says.

Who Can Benefit From Palliative Care?

Palliative care is for patients with serious illnesses, such as cancer or heart failure. It should be introduced as early as the patient starts experiencing symptoms that affect their quality of life. “Our goal is to be a part of the treatment team and build a relationship with patients as soon as possible, so we can maintain and preserve quality of life for as long as possible,” says Dr. Desai.

 Ideally, the palliative care conversation begins with the patient’s leading doctor when the patient is diagnosed. It works best when the health care teams the patient works with are all on the same page from the beginning. For patients currently undergoing treatment for a serious illness that are not using palliative care, Dr. Desai recommends starting the conversation.

 “For example, if a patient has cancer, I think it’s a good conversation to have with their oncologist,” says Dr. Desai. “You can ask, ‘Do you think palliative care would be valuable for me?’ We’re open to anyone who is interested.”

Dr. Desai offers and example of a patient who might consider palliative care:

• A patient with a history of smoking and coronary artery disease is diagnosed with lung cancer with metastatic tumors in the bone.
• The patient has met with an oncologist and is considering beginning cancer treatment, which may include surgery, immunotherapy, chemotherapy and radiation.
• Meantime, the patient is dealing with significant physical pain and shortness of breath.
• Additionally, the patient is concerned about the value of initiating cancer treatment due to the additional impact on their quality of life.
• In this case, palliative care could be beneficial to help the patient manage symptoms as well as continue conversations about their goals of medical care.  

 Dr. Desai encourages everyone to learn more about palliative care and its ability to improve quality of life for patients who may be dealing with many issues related to their disease and treatment. 

“The philosophy of palliative care is living your best life with the highest quality of life possible while you are living with a serious illness,” he says. “We want patients to have a high quality of life and high functionality for as long as possible. The sooner we’re able to get involved with a patient, the bigger the difference we can make.”

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.