By Anita Rao, ABC News Medical Unit
People with a serious or chronic illness often get lost in a healthcare system that seems focused on treating their illness and ignoring their symptoms. That's where palliative care, an emerging branch of medicine, comes in.
Palliative care aims to improve the quality of life for patients with serious illnesses and their families through symptom prevention, treatment and relief. It's provided by a team of specially trained doctors, nurses and other healthcare specialists who work alongside a patients' other doctors. Rather than treating the illness per se, palliative care offers comfort, symptom management and a focus on respecting the patient's medical care wishes.
This week, Dr. Richard Besser, chief health medical correspondent for ABC News, along with American Cancer Society Cancer Action Network, hosted a Twitter chat on palliative care to help readers better understand what it is, where to find it and how to ask for it when needed. A full chat transcript can be found here. For highlights from the chat, including some of the best tweets from participating experts, read on.
Who needs palliative care?
Palliative care is appropriate for anyone who receives a diagnosis for a serious or chronic disease. Anyone with cancer, heart and lung disease, renal disease, and dementia is a likely candidate to receive palliative care, regardless of the stage of the disease.
Fortunately, palliative care has grown exponentially in the past few years. Nearly 65 percent of hospitals with more than 50 beds - over 1500 hospitals - now offer some form of palliative care, according to the Center to Advance Palliative Care, a non-profit group based in New York City.
However, the Center notes that only 24 percent of people said they were familiar with the term palliative care. If you are a loved one are diagnosed with a serious illness, ask your treating doctor if palliative care is available and request a palliative care consultation.
— Diane E. Meier (@DianeEMeier) July 16, 2013
— Montefiore (@MontefioreNYC) July 16, 2013
What is hospice care?
Hospice and palliative care are commonly mistaken for one another. While hospice care focuses on patients with a life expectancy of 6 months or less, palliative care can be provided at any point during a person's illness. In fact, palliative care accessed earlier on can reap greater benefits, even if it involves simply contacting the palliative care team to find out what services are available. A 2010 study in the New England Journal of Medicine found that patients receiving early palliative care experienced less depression, improved quality of life and survived 2.7 months longer.
— Cory Ingram, M.D. (@cjingram) July 16, 2013
— Montefiore (@MontefioreNYC) July 16, 2013
How can palliative care help?
Palliative specialists make patients and families, rather than disease, their primary focus. They help patients and families arrive at an understanding of their situation and come to terms with their physical and emotional pain. Treatment addresses symptoms such as shortness of breath, pain, nausea, loss of energy and other concerns the patient may have. They help coordinate access to resources, help make sense of the treatment plan, and can even address spiritual needs. Besides doctors and nurses, a palliative caregiver may be a social worker, physical therapist, massage therapist or some other specialist whose job it is to increase patient comfort and support the family.
— Cleveland Clinic (@ClevelandClinic) July 16, 2013
#abcDRBchat Palliative care is especially important in our public safety net hospitals for patients already struggling with resources
— Dr. Pamelyn Close (@DrPamelynClose) July 16, 2013
What can I do?
To increase the chances of receiving palliative care, it helps to have a plan in case of medical misfortune. Experts advise having a checklist for advanced care so a patient and his loved ones can be present for one another during the time when they need it the most. Write a living will that specifies which medical treatments and life-sustaining measures you want or don't want including mechanical breathing, tube feeding or resuscitation. Designate a person to make medical decisions on your behalf should you become unable to do this yourself. Consider a "Do Not Resuscitate Order" that specifically requests not to have a tube in your throat, chest compressions or electrical shocks if you stop breathing or your heart stops.
— Columbia Nursing (@CU_Nursing) July 16, 2013
The most important conversations on palliative care can't fully transpire in 140 characters. But we can start here. #abcDrBchat
— Rep. Emanuel Cleaver (@repcleaver) July 16, 2013