What is palliative care?
Palliative care is both a philosophy of care and a highly structured system of care. The goal of palliative care is to relieve suffering and improve the quality of life for patients with advanced illness. It includes the physical aspects of care as well as the emotional, social and spiritual needs of the patient and family.
What are the benefits of palliative care for a patient and their family?
Both patients and their families benefit from palliative care. The goal of palliative care is to develop and coordinate a plan of care that:
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Involves the patient in talking and making decisions about their care
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Supports the patient and family in making informed decisions
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Provides supportive education regarding the disease process
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Provides relief from pain and other distressing symptoms
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Incorporates psychological and spiritual aspects of care
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Develops support systems for the patient/family
What types of treatments are involved in palliative care?
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Pain and symptom control: The palliative care team will identify a patient's sources of pain and discomfort. These may include problems with breathing, fatigue, depression, insomnia, or bowel or bladder. The team will provide treatments that can offer relief. These might include medication, massage therapy or relaxation techniques, or other options.
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Emotional and spiritual support: Palliative care focuses on the entire person, not just his or her illness. The team members caring for a patient will address any social, psychological, emotional or spiritual needs.
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Family/caregiver support: The palliative care team will fully explain treatment options to help a patient achieve the best possible quality of life during his/her illness. The patient and their family can determine goals of care that will guide decision-making.
Can a patient continue to receive treatments to cure their illness?
Palliative care is appropriate at any stage of an illness and can be provided at the same time as curative treatment.
Who delivers palliative care?
Care continues to be provided by the patient's attending physician with the addition of the palliative care interdisciplinary team, which can include nurses, social workers and chaplains. The entire team will assist the attending physician and the patient/family to formulate a palliative plan of care and support this plan.
Where is palliative care delivered?
Aimed at helping patients who have serious, chronic, debilitating, or sometimes life-threatening conditions with an unpredictable prognosis, palliative care may be provided in the hospital, nursing home, or in the home setting. St. John Health offers palliative care at all of our hospitals, nursing homes and in patients' homes through St. John Home Care.
Who is eligible for palliative care?
Palliative care is for all patients with debilitating chronic and life threatening conditions from the point of diagnosis and regardless of prognosis. It covers all age groups and all diagnoses. Eligibility is based solely on patient and family need for palliative care. It is delivered concurrently with all other appropriate curative or life prolonging measures. Illnesses may include cancer, heart disease, chronic lung disease, dementia, stroke, and other advanced illnesses such as HIV/AIDS.
What is the difference between palliative care and hospice?
Palliative care and hospice are not the same. Both provide care that emphasizes patient goals, relief of pain and suffering, and quality of life, but hospice focuses on end-of-life care needs. Palliative care can be of benefit earlier in the course of the illness when no defined prognosis is established and the patient is still seeking curative therapies. Hospice provides care to a patient and who has a terminal diagnosis with a life expectancy of about six months or less, and is no longer seeking life-prolonging care. Palliative care and hospice often work together, helping patients and families on their journey near the end of life.
What is the St. John Health / Duke Palliative Care Project?
St. John Health and the Duke Institute on Care at the End of Life have launched a three-year collaborative project to improve access to palliative and end of life care for all St. John Health patients. The project's goal is to educate patient care teams on how to evaluate patients for palliative and end of life needs, and assure that all patients and their families receive compassionate care with attention to their spiritual, psychosocial and clinical needs as they confront advanced illness.
Although all SJH hospitals provide palliative care, St. John Hospital and Medical Center was selected as the pilot site for the project. Other SJH sites will share in the benefits of the education and training provided and the tools developed.
What makes the St. John Health / Duke Palliative Care Project pioneering?
To the best of our knowledge, no other health system is attempting to reach all patients, regardless of where they enter the system. We'll do this by using a 'universal screening tool' to determine need. We'll test this tool in a pilot unit in a pilot site, always with an eye towards implementing the tool (or a version thereof) in all venues.
What role does spiritual care have in the project?
Many health systems are developing palliative care teams of doctors and nurses, with involvement of spiritual care providers as a secondary consideration. This project acknowledges that whole person care does not exist without attention to spiritual distress and will design a realistic way to assess and respond to these needs.
How can a palliative care consult be initiated?
Anyone can request a palliative care consult, however only the patient's attending physician can initiate a palliative care consultation by writing an order for it. Palliative care consults can be provided in the home, hospital, nursing home, and assisted living facilities.
For more information about palliative care at St. John Health, call Rhonda Bishop at (313) 343-4476.
