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Palliative Care (PC) is a relatively new specialty area in healthcare delivery. Nursing, medicine, and several other disciplines are offering palliative care-specific education to enhance healthcare provider knowledge. PC is focused on helping patients diagnosed with chronic (not curable), life-threatening, and/or serious injuries/illnesses (potentially curable). Therefore, the primary goal of palliative care is to enhance the quality of life for the patient and their family, by anticipating, preventing, and treating symptoms and suffering from illness. PC is not limited to one specific population but rather serves all age groups, including neonates, children, adolescents, young adults, and older adults, across all healthcare settings. To attain this goal an interdisciplinary PC team of doctors, nurses, allied healthcare providers, and others focus on the patient’s and family’s/caregiver’s needs, not just on the illness or injury. This interdisciplinary approach requires a new emphasis on provider-patient and provider-provider communication by coordinating care and addressing not just traditional therapies, but also spiritual, psychological, and emotional support for the patient and her/his family or caregivers.

As discussed above, Palliative Care is a broad specialty area that includes patient care from diagnosis with a chronic or serious disease or injury to death. Therefore, hospice is one aspect of Palliative Care. They are both governed by the same values, beliefs, and goals—to provide the best quality of life for the patient, but in addition, for hospice patients—the best quality of death. However, it should be understood that eligibility for hospice care from an insurance (Medicare, etc.) perspective requires patients to be diagnosed by two separate physicians with a terminal disease and have a prognosis of six months or less to live. Adult patients who are in a hospice care setting can leave, by their own accord at any time. In addition, if patients want to stop hospice care and return to chemotherapy, or have surgery—they can do so whenever they choose.

For children, palliative care can be offered concurrently with hospice care. For example, children with cancer can continue to receive chemotherapy while receiving the hospice benefit.

No, as discussed in #2, Palliative Care is not disease/injury-focused. Instead, PC is patient/family/caregiver-centered and whether a patient is newly diagnosed with diabetes, cancer, or other chronic illness, or has a serious brain or spinal cord injury—Palliative Care is intended to help that patient and his/her family/caregivers attain the best quality of life possible. The focus is on the patient and his/her wishes, needs, and/or desires. This is the same approach for children, adults, and the elderly. One approach that is patient-centered, not disease, injury, or provider-focused.

Palliative Care is appropriate for a wide array of chronic diseases, serious injuries, and terminal prognoses. Specifically, some of these illnesses/injuries (from their first diagnosis to a terminal prognosis) include:

• Alzheimer’s Disease/Dementia
• Traumatic Brain Injuries
• Cerebrovascular Accidents (CVA)/Strokes
• Cancers
• Chronic Obstructive Pulmonary Disease (COPD)/Emphysema
• Congenital Syndromes/Anomalies
• Congestive Heart Failure (CHF)
• Coronary Artery Disease/Angina
• Cystic Fibrosis
• Diabetes (Type 1 and Type 2)
• Genetic Conditions
• Hematologic Disorders
• Hypertension (high blood pressure)
• Immunodeficiency Disorders
• Neurologic/Neuromuscular Disease/Amyotrophic Lateralizing Sclerosis (ALS)/Lou
• Gehrig’s Disease/Parkinson’s Disease/Multiple Sclerosis/Muscular Dystrophy
• Spinal Cord Injuries/Paraplegia or Quadriplegia

Regardless of the disease or injury that creates the need for a palliative approach—the goal is always the same—patient-centered, quality-of-life-focused care. While most of the diseases and injuries listed in #4 are incurable, they all can be treated in ways that minimize a patient’s pain and discomfort while maximizing her/his abilities to attain realistic self-determined health/life goals (walking, playing with siblings/peers/children/grandchildren, traveling, and so forth). The benefits for the patient, as well as her/his family/caregivers from a Palliative Care perspective, are more control and empowerment in health care decision-making, effective pain and symptom management, and an interdisciplinary team approach to improving the patient’s and the family’s/caregiver’s quality of life—physically, emotionally, and spiritually.

The Palliative Care Interdisciplinary Team (IDT) is a unique approach to patient-centered, quality-of-life-focused healthcare delivery. Instead of the traditional, hierarchical, physician-leader method that is generally the norm, an IDT uses a broad array of providers and caregivers to help ensure that a patient’s physical, emotional, and spiritual health—not just his/her disease, is everyone’s foci. An IDT is generally comprised of many of the following Palliative Care providers:

• Nurses (RNs & Advanced Practice Registered Nurses (APRNs)
• Doctors
• Physician Assistants
• Physical and/or Occupational Therapists
• Social Workers
• Pharmacists
• Chaplains
• Music &/or Art Therapists (if on staff)
• Child Life Specialists (pediatric PC)

The goal of the IDT is to find the most effective ways to provide the patient, family, and/or caregivers with the quality of life and care the patient desires. By utilizing an interdependent, interdisciplinary team approach the staff seeks to find a collaborative and participative method(s) for attaining the patient’s health and quality of life goals.

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