March 25, 2021
By Sabiha Pasha, M.D.
What is palliative care? Debunking the “end of life” stigma.
Palliative care is a lot of things, but “end of life” care it is not. At its roots, it is care to keep living.
Whereas hospice focuses on the last months of someone’s life, palliative care is concurrent with a patient’s illness – ideally, starting at initial diagnosis through any treatment or post-treatment adjustments.
Serious illnesses cause serious, almost unfathomable disruption across a person’s life. The goal of palliative care is to holistically address issues affecting quality of life and improve patient comfort. This can mean tackling someone’s emotional, financial, psychological, social and physical well-being.
In addition, palliative care also emphasizes planning. This can include the choices for medical treatment, organizing medication, juggling family or health visits, writing wills, tackling finances and all the other small or large details that should be pinned down. These conversations and details are daunting in the best of times, let alone when battling an illness. Working with a trained professional to plan for and confront these issues relieves many burdens.
Palliative care is for anyone living an “adjusted life.” It is for people of any age. It is provided on an ongoing basis or for a short period of time, depending on the individual’s needs. Perhaps most importantly, it places an emphasis on the patient, and not the disease, as the primary focus of care.
Harnessed to its fullest, it can bring hope, a sense of control, and a chance at a better quality of life for patients and their caregivers.
Better living through medical science
I mentioned earlier that palliative care should be a part of the care from the onset of the diagnosis of a serious illness. This is based on growing evidence of the positive impact of this care on quality of life.
Most notably, a landmark New England Journal of Medicine study found that early palliative care not only improved quality of life and symptoms of anxiety and depression, but also improved survival in patients with lung cancer.
The connection to quality of life cannot be understated. Medical science enables all of us to live longer lives, which also means our population is getting older and sicker. If my patients have taught me anything, it is that the quality of those days does matter.
As a result, palliative care can look very different from patient to patient.
For a patient with cancer, for example, an oncologist could collaborate with a team to harness a home health aide to provide support to the family or a nurse practitioner to incorporate ways to manage the nausea, loss of appetite or pain that comes with treatment. It could also mean working with community resources to address the financial stress of being too sick to work or the social isolation that can come from missing out on typical activities.
This focused care helps patients feel better, both physically and mentally.
My surprising life lesson from palliative care
In 2005 I was introduced to palliative care. It promised to restore autonomy and dignity to the chronic and seriously ill. To focuses on quality of life as defined uniquely by the patient. To support the family even while ameliorating pain and other uncomfortable symptoms.
It was exactly what my patients needed. As it turns out, the training and certification was exactly what I needed. Palliative care catapulted me onto a path of self- discovery, compassion and resiliency. Every day I am a witness to fear and courage. And I have learned to be still and just be present.
Ultimately, suffering is a part of life and having someone to hold your hand even for a moment can ease the pain. Palliative care is not rocket science, but it is the one last bastion where the art of healing lives on.