By Jude Roberts, Staff Writer
The word palliative means to “lessen
the severity of without curing; to alleviate.”
This type of care is considered to be a form of
pain management, also referred to as supportive
care, given throughout all stages of cancer or
other life-threatening diseases. For example, a
person who is receiving cancer treatment may
experience nausea and vomiting as a side effect.
Treating the symptoms of nausea and vomiting
throughout chemo or radiation is considered to
be palliative care, easing the symptoms and side
effects, but not providing an actual cure for
the disease. Aside from easing physical pain,
one of the primary goals of palliative care is
to help improve the quality-of-life for a loved
one and their family. By trying to incorporate
the total person in meeting their social,
emotional and spiritual needs, palliative care
is meant to be a relief of symptoms, rather than
a cure. The comfort level of a loved one and
that of their family is the main focus of
palliative care. By enabling the caregiver to
play an important role in easing their loved
one’s pain (physically, mentally, and
emotionally) and with a loved one having their
pain eased for them, both will find that their
quality of life will greatly improve.
Palliative care, used throughout the course of a
disease like cancer, is generally increased once
there are no new treatment options left, and
during the last year of life. Some of the more
common symptoms that palliative care can help
relieve and control include: pain; difficulty
breathing; loss of appetite and weight loss;
fatigue; weakness; problems with sleep; anxiety
and depression; and confusion. Aside from easing
the physical aspects of a life-threatening
disease, palliative care also provides: advance
care planning (for someone who has a few months
to a year to live), social support for both
caregiver and loved one, complex care (someone
who may have a history of mental problems or
substance abuse, along with a life-threatening
disease), and specialized care during the final
days and hours. When someone is given a few
months to a year to live, it’s important to
begin the process of advance care planning. A
doctor will determine what the palliative care
options are (including hospice), and can be the
one to introduce you and your loved one to a
palliative healthcare team. At this point, an
open discussion is needed between caregiver and
loved one regarding the option of palliative
care, how the person feels about palliative
care, and what their preferences are when it
comes to their end-of-life care. Once palliative
care has been decided upon, the palliative care
team can then begin to assess the needs of the
loved one, comparing their requests with those
of the caregiver. Some of what will be discussed
may be rather uncomfortable for everyone, but
it’s important to move forward with this aspect,
since this will be the only way to know the true
wishes of a loved one. The palliative care team
will discuss the need for advance directives,
such as a living will, power of attorney for
healthcare (sometimes referred to as the durable
power of attorney for healthcare), and whether
or not resuscitation will be required and/or
requested at any point in their care (a “DNR”
order means “do not resuscitate”; it’s signed by
the person, and kept in their chart or on file
with their medical team). These directives also
include information about where the person
wishes to die, who will serve as the healthcare
proxy (a caregiver who knows the final wishes of
a loved one, and sees to it that their wishes
are respected), as well as a loved one’s wishes
regarding whether or not they want to donate
their organs or have an autopsy.
The social support offered through palliative care
includes making sure that a person is receiving
attention from their family, community, and from
their religious or spiritual leader/family. The
palliative care team will also ensure that a
person’s home environment is safe and comfortable,
that they have a caregiver to help them at all
times, and that transportation is available for
hospital or doctor visits. They will also make sure
that caregivers and loved ones have the financial
resources needed, and give caregivers the support
and education they will need in order to provide
good, consistent care, and providing them with help
for their own needs and stresses.
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