In late June, Sens. Jacky Rosen, D-Nevada, and Lisa Murkowski, R-Alaska, introduced bipartisan legislation that would update public health service programs to include palliative care medicine as an eligible primary-care service. This is a much-needed update to national health care policy. Palliative care is proven to improve outcomes and lower the cost of treatments, Rosen said in announcing the legislation.
“When a patient receives a serious medical diagnosis, the list of symptoms and side effects from the illness and its treatments can be extensive. For those patients, palliative care plays a significant role in minimizing pain and discomfort and maximizing quality of life,” Murkowski said . “By officially recognizing palliative care as a subspecialty of public health services, we're opening the door for those working in the industry to access the training they need to give their patients the quality care they deserve.”
What is palliative care?
More than 70% of Americans have never heard of palliative (pronounced pal-lee-uh-tiv) care – specialized medical care for people with serious illnesses. It focuses on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for the patient and the family.
Like hospice care, palliative care focuses on patients' comfort through medication and other therapies. Those who continue to seek curative treatment can receive palliative care throughout their treatment. Hospice is a type of palliative care, and its goal is similar: patient comfort. A person can choose hospice care when he or she decides to forgo further curative treatment and has a life expectancy of six months or less, should the disease follow its normal course.
Palliative care can begin at diagnosis and can be continued through curative treatments. For example, a patient diagnosed with lung cancer can immediately begin chemotherapy and palliative care simultaneously. Palliative care for those undergoing chemotherapy, for example, can include medications to treat nausea, shortness of breath and pain.
Palliative care is provided by a specially trained team of doctors, nurse practitioners, nurses, social workers and other specialists who work together with a patient's 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.
Improved quality of life
Palliative care teams specialize in treating people suffering from the symptoms and stress of serious illnesses such as cancer, congestive heart failure, chronic obstructive pulmonary disease, kidney disease, Alzheimer's, Parkinson's, amyotrophic lateral sclerosis and many more. Symptoms may include depression, pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping and much more.
The palliative care team spends time communicating deeply with patients. They will give patients control over their care by exploring their goals and helping them understand their options. They will help patients gain the strength to carry on with daily life and improve their quality of life.
Palliative care also saves money. Within the next two decades, palliative care has the potential to reduce societal health care costs by $103 billion, according to the nonprofit economic research group Florida TaxWatch. Research published in the July 2017 issue of Health Affairs estimated that palliative care could reduce health care costs by more than $4,000 per patient.
Palliative care also reduces the frequency of 911 calls, emergency room visits and unnecessary hospitalizations, according to the Health Affairs study.
Palliative care teams work together with patients' other doctors and patients' families. Close communication is key. The palliative care team spends as much time as necessary communicating with the patient, family and other doctors. The core team includes doctors, nurse practitioners, nurses and social work palliative care specialists. Massage therapists, pharmacists, nutritionists, chaplains and others may also be part of the team.
When one is diagnosed with a serious, potentially fatal illness, many emotions come to the forefront. Fear of pain, fear of treatments, fear of what happens next. I urge anyone in this situation to ask for a palliative consultation with your doctor or your hospital's palliative care team. Visiting Nurse also offers palliative care consultations at Lutheran Hospital and at our clinic on West Jefferson Boulevard.
Leslie Friedel is CEO of Visiting Nurse.