Palliative care is specialized medical care that focuses on providing patients relief from pain and other symptoms of a serious illness. Palliative care can be received no matter the diagnosis or stage of the disease. These illnesses include cancer, heart disease, cystic fibrosis, dementia, kidney failure, lung disease, Parkinson’s, and stroke.
Palliative care professionals aim to improve patients’ and their families’ quality of life. This form of care comes alongside other treatments patients may receive. It is appropriate at any stage of a serious illness. This care is provided by a team of doctors, nurses, and other specially trained people. They work with the patient, their family, and their doctors to provide an extra layer of support.
What kind of impact does palliative care have on oncology patients?
Rachel Wixson, a Palliative Care System Management Director, tells the story of one of her former patients, Sara, who had curable bladder cancer and came into the hospital with horrible pain, nausea, and vomiting. Sara didn’t want to get treatment because of how miserable she felt. She even asked about “Death with Dignity,” Oregon’s medical-assisted suicide program. She didn’t qualify for Death with Dignity because she had more than six months to live and a curable diagnosis. Sara was rapidly declining, despite the fact that she had a curable cancer. She was in too much pain to consider treatment options.
“Why would I want to live if this is my state of life?” Sara asked Rachel.
“I cry every morning when I wake up. Do you want to know why?”
“Yes” said Rachel.
“Because I woke up” Sara said.
After a necessary pause, Rachel responded, “Let’s take treatment off the table and focus on your symptoms and improving your quality of life. Can you give me a week?”
Sara gave Rachel four days. Rachel knew she had a limited time frame and made several changes in Sara’s medication.
A New Turn
The next day, Rachel walked into Sara’s room. Sara was sitting on the bed chatting and laughing with her husband. Rachel said, “When I walked through the door, she looked at me and said, “I didn’t cry this morning.”
Over the next 4 days, Rachel helped Sara get to a place where she was more comfortable. Next, Rachel brought in an oncologist and talked about possible treatment plans. Rachel explained what she would do to keep Sara comfortable during treatment. Sara started the treatment and Rachel followed her to the outpatient clinic.
“Our team kept her comfortable and 6 months later her cancer was gone. We tapered her off all of the medications and the last time I saw her the cancer was cured and she and her husband had just bought an RV and were heading out to tour the United States” Rachel said.
Rachel has many of these types of stories after being a Palliative Care Nurse Practitioner for six years. “I wanted to get into palliative care after seeing patients not getting clear-cut answers. Patients were often confused and I would see their quality of life not being addressed and I wanted to help improve their quality of life by helping manage their symptoms.”
What does this kind of care do for cancer patients?
Palliative care specialists work in partnership with physicians and help to provide:
- Communication to ensure that care matches the goals and priorities of the patient and the family
- Management of complex physical and emotional symptoms, including pain, depression, anxiety, fatigue, shortness of breath, constipation, nausea, loss of appetite, and difficulty sleeping
- Coordination of care plans among all providers and across all settings
Numerous studies show that this care significantly improves a patient’s quality of life by offering symptom management, support, and advice, care techniques that provide comfort, referrals, and advance care planning. According to the European Journal of Cancer, “Early palliative care in oncology results in improved quality of life throughout the disease trajectory, with the impact increasing toward the end of life. It also results in more patient-centered care.”
Research supports the benefits of Palliative Care including:
- improvement of patients’ quality of life
- improvement of symptoms
- keeping patients out of the hospital
- helping patients live longer
According to the Annals of Behavioral Medicine, “Patients receiving outpatient specialty palliative care have a 14% absolute increase in 1-year survival relative to controls with a median survival of 4.56 months longer.”
Is hospice care different?
Palliative care is different from Hospice Care. At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. Hospice is designed for this situation. The patient beginning hospice care understands that his or her illness is not responding to medical attempts to cure it or to slow the disease’s progress. Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life.
Available for Wheelhouse members
If Wheelhouse members need palliative care, the member’s CancerAlly/Oncology Nurse Navigator can recommend a nurse to them. Partnerships Wheelhouse acquired with industry experts makes this possible.
Rachel continues to explain, “I think it’s incredibly forward-thinking of Wheelhouse to be promoting integrative palliative care as part of an inpatient setting. This early integrated palliative care is the best way to provide palliative care. The vast majority of palliative care is in hospitals and that is really “crisis” palliative care because patients are coming in with failure to thrive where treatment is not working, where cancer is progressing despite various treatments. So, this early palliative care where I can see patients as they go through their journey is how palliative care should be done, where we can be there from the beginning. It shows Wheelhouse’s commitment to the quality of patient care and I’m happy to be part of their team.”
