What is Palliative Care?
Palliative care is a specialized form of medical treatment that treats patients with serious illnesses such as heart failure, kidney failure, cancer, lung diseases, and more. It helps people with these illnesses feel better by preventing or treating systems along with the side effects of the disease while also helping patients and their families live with the daily changes that serious illness presents.
As palliative care’s goal is to make patients feel better, it is often narrowly thought of as a way to reduce pain. However, what palliative care means goes beyond pain relief as it also treats social, spiritual, emotional, and practical problems that accompany the disease. When patients feel better, they usually have a better quality of life. Palliative care can be administered simultaneously as a treatment for an illness or multiple illnesses and can continue beyond such time that treatment to halt disease progression has been deemed ineffective. Patients may also get palliative care as part of an end-of-life plan.
Who Administers Palliative Care
Any health care professional can provide palliative care. It may be administered in several different settings including hospitals, clinics, cancer centers, nursing homes and rehabilitation centers, and even in your residence through home health care services provided by agencies like Centric Healthcare. Usually, a team of associated professionals will provide palliative services. Members of a palliative team will include:
- Nurses or nurse practitioners
- physician assistants
- Social workers
When Should Someone Be Offered Palliative Care?
In short, patients should be offered the opportunity to take advantage of palliative care anytime that they face a major disease or illness. Many times, an offer is not forthcoming and a patient or his or her caregivers must ask for it. If it’s not offered to you, ask for palliative care early in your illness. Those diagnosed with advanced cancer should request palliative care within eight weeks of their diagnosis.
Patients and their families can expect palliative care services to provide an extra layer of support for patients experiencing severe illness. In addition to relieving symptoms and distress, you can expect your team to do the following:
- Help you better understand your diagnosis and disease
- Clarify treatment goals and options
- Understand and support your ability to cope with challenges
- Assist in making medical decisions
- Coordinate care with doctors
In general, the type of disease or combination of diseases dictates whether one qualifies for palliative care. The most common ones include:
- Heart disease
- Cancer of all types
- Lung disease
- Alzheimer’s and dementia
Qualifying heart problems including congestive heart failure. Chronic obstructive pulmonary disease (COPD)also qualifies, as well as Parkinson’s disease, Eosinophil Associated Disease (EAD)
Palliative care can be essential for patients with long-lasting COVID-19 symptoms, as well as other medical problems such as Huntington’s Disease, leukemia and lymphoma, liver disease, multiple myeloma, multiple sclerosis, pulmonary fibrosis, sickle cell anemia, and stroke.
While the illness or disease often dictates whether a person initially qualifies for palliative care, other complications also factor into the decision. For example, to qualify for care, patients also need to experience problems such as shortness of breath, anxiety, fatigue, lack of appetite, nausea, and constipation. Other typical problems include frequent emergency room admissions due to problems, treating side effects, eating problems.
Coping with the stress of the illness is another qualifying factor, as are eating problems and difficult side effects from treatment. The stress of a serious illness also qualifies whether it is something experienced by you or your family members. Emotion or spiritual and religious support extends not only to the patient but also to members of his or her family.
How Can I Get Palliative Care
This first step is to talk to your doctor to get a referral for this service. When talking to your doctor, ask where palliative care is available in your area. Explain exactly what quality of life means to you, whether it’s relief from pain or spending time with loved ones, or having the ability to make your own decisions. Tell your doctor what treatments you want and those you don’t.
Discussing planning for future care is also important as circumstances can change. Make sure you do this whether you are well or early into the illness. Another important consideration is if you have a living will or health care proxy. Make sure that all pertinent individuals have a copy of the document.
Types of Palliative Care
Making sure that someone is as comfortable as possible isn’t the only aspect of this type of medical care as it is holistic, taking care of mind and body. Supportive care has several different aspects that you may not have considered. Supportive care for physical aspects of illnesses is what most people think of when palliative care is mentioned. These can include pain, fatigue, nausea, vomiting, and loss of appetite, breathing problems, and sleep problems. Certain medicines and specialists can provide care for these concerns.
However, many seriously ill patients find it difficult to talk about various parts of their life. In addition to medical concerns, palliative care can help you take care of the following parts of your life.
Talking with a loved one or friends can be difficult for those experiencing serious illness. A social worker can provide support in these instances by arranging things such as participation in a support group, rides to treatment, planning family meetings, helping to find all types of pertinent information. Social workers can also relieve the concerns of family members who may also feel overwhelmed.
Emotional and Mental Health Support
Common emotions of patients suffering from serious illness include sadness, anxiety, and anger. Many symptoms, treatments, and medications can also affect patients’ mental outlook. Stress and anxiety are also factors. Counselors, psychologists, and other specialists can provide palliative care to help patients work through and cope with their feelings. Recommendations may include exercise, meditation, support groups, and sometimes medication to help with anxiety, depression, or sleep problems. Counselors and others may suggest activities such as yoga, creating art, or joining a support group to relieve stress and anxiety.
Having a serious illness or chronic condition can bring up spiritual issues. Patients who belong to a faith community often seek support from leaders or other community members. Hospital chaplains may also provide spiritual support even for those who are not religious.
Disease treatment is expensive and can cause stress and anxiety for patients and their families. Social workers or financial counselors can help with various concerns and may be able to help with billing and insurance, help our apply for medical leave or disability payments and find programs that provide free or low-cost prescriptions.
What is Included in Palliative Care?
In short, you can get all of the above-mentioned services in a palliative care plan, but your circumstances as well as what your insurance will pay for may dictate what services you can receive. At the very least, you can expect insurance to cover supportive care for the following:
- Trouble sleeping
- Shortness of breath
- Loss of appetite and nausea
- Nutritional guidance
- Physical therapy
- Occupational therapy
- Integrative therapies
Many patients and family members also ask does Medicare cover palliative care? Medicare does not use the term palliative care, but those who have Medicare generally have services that fall under this term covered by Part B insurance. the care provider bills Medicare for provided services, but you should understand what co-pays or fees that you may have to pay or that your supplemental insurance may have to pick up. It’s wise to request a fee schedule before requesting services and to check with your supplemental insurance to see what is covered.
Medicaid does not use the term palliative care, either, so standard benefits provide coverage. Similarly, many private health insurers also provide some support care services.
If you are covered by Medicaid, a health insurance plan for people with low income and few assets, it may cover some palliative care treatments and medications, including visits from doctors. Medicaid does not use the term palliative, so standard Medicaid benefits provide coverage. The palliative care provider (the organization offering you the services) will bill Medicaid for services provided, but be sure you understand what co-pays or fees if any, you will be asked to pay. Ask about your responsibility for fees and request a fee schedule before agreeing to receive services. Most private health insurance plans provide some level of coverage for palliative care. It’s also a typical component of long-term care policies.Many private health insurance plans provide some coverage for palliative care as part of their hospice or chronic care benefits. If you own a long-term care policy, there may be palliative care benefits provided by that policy. Check with your health insurance or long-term care insurance representative. U.S. military veterans should check with the Department of Veterans Affairs to see what benefits they may receive.
What is the Difference Between Palliative Care and Hospice?
Many people think palliative care and hospice are the same things, but it is not. However, palliative care is often a component of hospice. Both types of care are an approach to illness, yet hospice care is more applicable to end-of-life-wishes, whereas comfort care can apply at any time during the illness process.
Hospice care applies when it becomes obvious that treating an illness is not possible. The patient also understands that beginning hospice care means that his or her illness is not responding to treatments to cure it. Hospice care is usually provided to patients who have six months or less for an illness to run its course, resulting in death. Like palliative care, however, hospice may occur in a variety of medical settings, including one’s home.
The difference between hospice care and palliative care lies in the approach to services. Advance care planning is usually a component of hospice care as greater attention is paid to end-of-life wishes as death has been deemed imminent for the patient. If you are a caregiver working with an end-of-life patient, you need to consider the patient’s wishes when terminating treatment that may prolong life. Life-saving treatments stop in hospice care, which is the most notable difference. All other supportive care may continue as long as the patient continues to live.
How Centric Healthcare Can Help
Providing comfort care to seriously ill individuals can make a difference in the lives of those patients and their families. Centric Healthcare has a variety of services that can help ill patients no matter what their age. We can help provide palliative services for your loved one, no matter what their age. From skilled nursing care to companionship and everything in between, Centric Healthcare has the personnel in the Twin Cities and Rochester areas to help improve your quality of life. Contact us today for an assessment to learn how we can help you or your loved one.