Palliative Care

This morning I heard this term of "Palliative Care" which is new to me. This is my short literature study about it.

Palliative care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family. It is based on the needs of the patient, not on the patient’s prognosis. The goal of palliative care is to relieve suffering,  gain the strength to carry on with daily life and provide the best possible quality of life for patients and their families. The patient does not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. 

Over time, if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities. Palliative care could transition to hospice care if the doctor believes the person is likely to die within six months or, the palliative care team could continue to help with increasing emphasis on comfort care.

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. Hospice is designed for situation where it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. Sometimes, people don't begin hospice care soon enough to take full advantage of the help it offers. Hospice care can be done at home or in a facility such as a nursing home or hospital. Stopping treatment aimed at curing an illness does not mean discontinuing all treatment. For example the chemotherapy is stopped as the cancer is not responding to it but if the person has high blood pressure, he or she will still get medicine for that.

The National Institute on aging considers comfort care, "an essential part of medical care at the end of life." It is also called end-of-life care. This type of care does not happen only in the moments before breathing ceases and the heart stops beating. Older people often live with one or more chronic illness and need significant care for days, weeks, and even months before death.

The end of life may look different depending on the person’s preferences, needs, or choices. Some people may want to be at home when they die, while others may prefer to seek treatment in a hospital or facility until the very end. Many want to be surrounded by family and friends, but it’s common for some to slip away while their loved ones aren’t in the room. When possible, there are steps you can take to increase the likelihood of a peaceful death for your loved one, follow their end-of-life wishes, and treat them with respect while they are dying.

People who are dying or suffering from a serious illness need care in four areas: physical comfort (e.g. pain), mental and emotional needs, spiritual issues, and physical tasks. 

Not everyone who is dying experiences pain. For those who do, experts believe that care should focus on relieving pain without worrying about possible long-term problems of drug dependence or abuse. Struggling with severe pain can be draining and make the dying person understandably angry or short-tempered. This can make it even harder for families and other loved ones to communicate with the person in a meaningful way.

End-of-life care can also include helping the dying person manage mental and emotional distress. Someone who is alert near the end of life might understandably feel depressed or anxious. It is important to treat emotional pain and suffering. Medicine may help if the depression or anxiety is severe.

The dying person may also have some specific fears and concerns. He or she may fear the unknown, or worry about those left behind. Some people are afraid of being alone at the very end. These feelings can be made worse by the reactions of family, friends, and even the medical team.

And some people may experience mental confusion and may have strange or unusual behavior, making it harder to connect with their loved ones. This can add to a dying person's sense of isolation.

For people nearing the end of life, spiritual needs may be as important as their physical concerns. Spiritual needs may include finding meaning in one's life, ending disagreements with others, or making peace with life circumstances. The dying person might find comfort in resolving unsettled issues with friends or family. Visits from a social worker or a counselor may help.

Many people find solace in their faith. Others may struggle with their faith or spiritual beliefs. Praying, reading religious texts, or listening to religious music may help. The person can also talk with someone from their religious community.

Family and friends can talk to the dying person about the importance of their relationship. Friends can share how they value years of support and companionship. Sharing memories of good times is another way some people find peace near death. This can be comforting for everyone. 

 Sometimes, a dying person may appear to see or talk to someone who is not there. Resist temptation to interrupt or correct them, or say they are imagining things. Give the dying person the space to experience their own reality. Sometimes dying people will report having dreams of meeting deceased relatives, friends, or religious figures. The dying person may have various reactions to such dreams, but often, they are quite comforting to them.

A person who is dying might be worried about who will take care of things when they are gone. A family member or friend can offer reassurance. You also may remind the dying person that their personal affairs are in good hands. 

In the end, consider that there may be no “perfect” death so just do the best you can for your loved one. The deep pain of losing someone close to you may be softened a little by knowing that, when you were needed, you did what you could.