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Wed March 27, 2013
What is palliative care and why should we talk about it?
How much do you know about palliative care?
If your answer is, 'not a lot,' you're not alone.
Though palliative care can serve an important role in a patient's life, it doesn't get much attention.
Let's start off with a definition from Dr. Sekaran.
Dr. Nishant Sekaran is an Assistant Clinical Professor of Medicine at the University of Michigan, and is the author of reports about the growing palliative care industry in Michigan that Michigan Radio is airing this week.
"When I talk to my patients, we are going to be very aggressive about focusing on your quality of life," said Sekaran. "That doesn't mean that you can't also be aggressive with pursuing medical therapy that is consistent with your goals and wishes about your care. Palliative care is really about clarifying what the patient's goals of care are while focusing on the physical and psycho-social aspects of illness."
Typically, palliative care is directed toward patients who have a serious illness, regardless of the state of their diagnosis. Palliative care is similar to hospice care, in that it focuses on relieving patients suffering and compliments traditional medical care.
The big difference between hospice and palliative care is that hospice is associated with the last six months of life.
Palliative care often comes into play for elderly patients who are put in the hospital abruptly.
These patients often go through huge changes in their functional state and the way they mentally process information.
At that point, palliative care teams step in to help alleviate the emotional toll on patients and their families. These teams are multidimensional, consisting of primary clinicians, nursing assistants, physical therapists, chaplains and social workers.
Dr. Sekaran spoke with Rose Mark, who lived independently until she was put in the hospital for a recently developed heart condition.
"[Rose] really thought about the bigger picture of her life. One of the most poignant stories that she shared with us was her reconciling a very tense relationship with her son," said Sekaran. "When palliative care came and talked to her, that was one aspect that was very important to her that she needed to resolve. Not only were her physical needs attended to, but her emotional needs were attended to as well."
Doctors in Michigan are recognizing that benefits of palliative care extend to health care providers as well.
Michigan doctor David Share noted that, "Palliative care can achieve a substantial savings by avoiding expensive, unnecessary, non-value added care which frees up more resources to better organize care that better meets a patient's needs."
As doctors and researchers within the healthcare system begin to see the benefits of palliative care, the industry has gained momentum.
So, for families and patients who would like the guidance of a palliative care team, where can they find that support?
Sekaran said that though many larger hospitals in Michigan offer palliative support, such guidance is trickier to find in small facilities - specifically those with 300 beds or less.
Despite its varying availability, Sekaran noted that that doesn't diminish its importance.
So, what should we remember about palliative care?
"It offers specialized services that disentangle the complexities of medical care and make sure that the health system is better achieving their expectations. For providers, similarly, it's a service that can help them better understand their patients and that the treatments they are recommending are what patients actually want."
-Lucy Perkins, Michigan Radio Newsroom
To listen to the full conversation, click the link above.