Americans often confuse hospice care, which precludes aggressive medical treatment and usually requires a prognosis of six months or less, and palliative care. The nub of the difference is that a palliative care team can be providing pain relief, psychological and spiritual support — even as another medical specialist is aggressively trying to cure or treat disease.
Palliative services are designed to help patients and their families sort through their options — ome of which may help restore the patient, while others may increase suffering for a minimal health benefit.
Recognized in 2007 as a specialty by the American Board of Medical Specialties, palliative care focuses on improving quality of life, regardless of treatment choices.
It is provided by a team headed by a doctor or nurse trained in the specialty, says Dr. Porter Storey, executive vice president of the American Academy of Hospice and Palliative Medicine. Most teams have a social worker who can help families find community resources such as home health or nursing home care, and many have a professional chaplain to provide spiritual counseling. Other team members can include a patient’s other doctors, physical therapists, dieticians, pharmacists and volunteer caregivers.
Patients or their families can ask their physician for a consultation with a palliative care team. “We are often called in when things are complicated and no one knows what to do next,” says Storey.
Sometimes, the consultation will result in a patient deciding to forego further aggressive treatment. But that’s not always the case. “In my practice I’ve seen people who thought they couldn’t tolerate more chemo because of nausea,” says Storey. “When that problem is taken care of, they can get more treatment. We often enable people to get the treatment they need.”
But palliative care isn’t always available. A 2005 report by the American Hospital Association found palliative care teams available in 70 percent of U.S. hospitals of 250 beds or more — but only in 30 percent of all hospitals.
To arrange for a palliative care consultation, Storey says, call your hospital to see if they have a team. Or call a local hospice provider. While hospice organizations provide a different kind of care, most can help people find palliative care specialists. “Lots of hospices are trying hard to fill the gap, working in collaboration with palliative care,” says Storey.