By Victor Montour
Community Based Palliative Care is a multidisciplinary approach to specialized medical and nursing care for people with life-limiting illnesses. Front Range Hospice and Palliative Care focuses on providing relief from the symptoms of a patient’s disease process like, pain, physical stress, and mental stress of a terminal diagnosis and so on. The goal for Front Range Hospice and Palliative Care is to improve the quality of life for both the patient we serve and their family so all can live the best days possible.
Community Based Palliative Care is provided by a team of physicians, nurses, social workers, chaplain’s and other healthcare professionals who work together with the primary care physician and referred specialists and other hospital or hospice staff to provide additional support. Community Based Palliative Care is appropriate at any age and at any stage in a serious illness and can be provided as the main goal of care or along with curative treatment. The sooner patients are referred to a Community Based Palliative Care program the better outcomes patients and families have.
Although it is an important part of end-of-life care, it is not limited to that stage. Community Base Palliative Care can be provided across multiple settings including in hospitals, at home, and in skilled nursing facilities. Interdisciplinary palliative care teams work with people and their families to clarify goals of care and provide symptom management, psycho-social, and spiritual support.
Physicians sometimes use the term palliative care in a sense meaning palliative therapies without curative intent, when no cure can be expected (as often happens in late-stage cancers). For example, tumor debulking can continue to reduce pain from mass effect even when it is no longer curative. A clearer usage is palliative, noncurative therapy when that is what is meant, because palliative care can be used along with curative or aggressive therapies.
Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease or cause. This can include treating nausea related to chemotherapy or something as simple as morphine to treat the pain of broken leg or ibuprofen to treat pain related to an influenza infection.
Community Based Palliative Care increases comfort by lessening pain, controlling symptoms, and lessening stress for the patient and family, and should not be delayed when it is indicated. Evidence shows that end-of-life communication interventions decrease utilization (such as length of stay), particularly in the intensive care unit setting, and that palliative care interventions (mostly in the outpatient setting) are effective for improving patient and caregiver perceptions of care.
Community Based Palliative Care is not reserved for people in end-of-life care and can improve quality of life, decrease depressive symptoms, and increase survival time. If palliative care is indicated for a person in an emergency department, then that care should begin in the emergency department immediately and with referral to additional palliative care services. Emergency care physicians often are the first medical professionals to open the discussion about palliative care and hospice services with people needing care and their families.
In some cases, medical specialty professional organizations recommend that sick people and physicians respond to an illness only with palliative care and not with a therapy directed at the disease.
A World Health Organization statement describes palliative care as “an approach that improves the quality of life of patients and their families facing the problems 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.” More generally, however, the term “palliative care” may refer to any care that alleviates symptoms, whether or not there is hope of a cure by other means; thus, palliative treatments may be used to alleviate the side effects of curative treatments, such as relieving the nausea associated with chemotherapy.
The term “palliative care” is increasingly used with regard to diseases other than cancer such as chronic, progressive pulmonary disorders, renal disease, chronic heart failure, HIV/AIDS and progressive neurological conditions. Anyone with a life-limiting illnesses that is in need of symptoms to be managed is eligible for Community Based Palliative Care.
While palliative care may seem to offer a broad range of services, the goals of palliative treatment are concrete: relief from suffering, treatment of pain and other distressing symptoms, psychological and spiritual care, a support system to help the individual live as actively as possible and a support system to sustain and rehabilitate the individual’s family.
If you or your family would like to know more about Front Range Hospice and Palliative Care and our palliative program please call us at 970-776-8080 or 303-957-3101.