The Taboo Topic: Palliative Care

What is Palliative Care

According to The World Health Organization the definition of Palliative Care is the following: Palliative Care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical psychosocial and spiritual.

Palliative Care Demographic

The traditional model for Palliative Care focused on terminal cancer yet the program has begun to extend to all patients with any kind of advanced chronic conditions. In high-income countries, it is estimated that 75% of the population die from chronic condition unrelated to cancer, making chronic conditions more of a prevalent challenge to the older adult. Over 50% of the population over the age of 65 have at least 2 chronic conditions. Some of the current statics: (source: Palliative Care Medicine 2014, Vol 28)

  • Advance frailty 38%
  • Dementia 19%
  • Cancer 10%
  • Heart Disease 8%
  • Neurological 7%
  • Lung Disease 6%

What Does Palliative Care Entail?

Pain & Symptom Control: Sources of pain and discomfort that individuals feel could include problems with breathing, fatigue, depression, insomnia or bowel & bladder. Palliative care would focus on incorporating care & treatment to offer relief from those using interventions like medications, massage therapy or relaxation technique.

Communication & Coordination: Palliative care places an emphasis on the importance of communication between the patient, family and interdisciplinary team to ensure that needs are fully met. These include establishing goals for care, help with decision-making and coordination of care

Emotional Support: Palliative care focuses on the entire person, not just one diagnosis – this emphasizes addressing social, psychological, emotional & spiritual needs.

Family/Caregiver Support: Caregivers bear a great deal of stress too, so palliative care is meant to support them as well. This focused attention helps ease some of the strain that impacts

Talk About the Taboo Topic

I heard a daughter talking about her mothers terminal illness and she commented that no one ever gave her mother the option of dying gracefully. They spent over $150,000 and 18 months trying to cure her chronic condition. She stated that the Medicare System paid upwards of $500,000. She when on to say that her mother did not have any quality of life the last months of her time with her family. The woman wanted someone to give her and her mother an option where they could have spent sometime doing what her mother would have enjoyed, not running from one doctor or treatment to another. Sometimes we have another path, here are some questions to start that difficult but necessary conversation.

“Tell me what you understand about your illness.”
“What do you know about your cancer?”
“What have your doctors told you about your health?”
Develop an understanding of your loved ones priorities:
“What is most important to you?”
“It’s important to me to honor your wishes. To make the best recommendations, I need to understand your priorities better.”
“Are there things or projects you want to finish?”
“What is it that you really want from me/the health-care system/your doctors?”
“What could I do that would help you the most?”
Understand other influences on decision making
“Is your faith important to you?”
“Tell me about how your life philosophy guides how you make decisions.”
Assess your own perceptions and priorities of your loved ones situation by asking yourself these questions:
How can I help reduce my family members suffering?
How can I maximize my loved ones sense of control?
How will this procedure impact on the family (consider increased burden of care, financial strain, emotional stress)?
Am I acting in the best interest of my loved one?
Am I helping?

It is not an easy road but Palliative Care is an option. It is a decision you and your loved one can to make together. Many resources are available to you and here is one that you could access right now if you find this is the right time to talk about that taboo subject.

Photo by labspics

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