Saturday, January 18, 2014

Palliative and Hospice Care

Palliative Care focuses on relieving and preventing suffering.   This can be for people who are dying and for those that have an illness that won’t necessarily lead to death.   Because it is for all patients, whether they are dying or not, makes it different than Hospice Care that focuses only on patients with terminal illness.  The goal is everyone in the team involved.   It should include the physician, pharmacists, nurses, spiritual providers, social workers, psychologists, caregivers, and the patient.  It should address physical, emotional, spiritual and social needs of the patient.

What makes treatments palliative rather than just general treatment?   If they relieve symptoms without the intent to cure or fix the disease.  For example, providing pain relief for severe arthritis will not cure the arthritis but it will help the patient feel better.

During my mother’s illness, I found that doctors found both palliative care and hospice care to be a difficult path.   Doctors are taught to cure.   They are taught to find ways to extend life, even at the risk of decreasing the quality of life.   They are not taught to help someone without the path to a cure.   The funny thing was that once we switched the plan to palliative though, my mother’s health improved.   The drugs that were intended to extend her life made her sick.  The same drugs that were keeping her tumors at bay also caused severe respiratory distress.  She felt as if she was drowning and gasping for breath …. And in fact, she was.

I can’t prove it but I do believe that by abandoning the “curative” drugs that were supposedly increasing her lifespan, her life was actually extended because the QUALITY improved.  The New England Journal of Medicine published a 2010 study on terminally ill lung cancer patients that showed those receiving palliative care had a better quality of life and lived an average of three months longer than those who did not seek palliative care so there is some scientific proof to back my hunch.


  1. Like the fact that both posts hold promise, Brianna: Your introducing palliative care and the fact that your remarkable mother far-outlived (not long enough, I know, but clearly way past the norm) her pancreatic cancer diagnosis.

    Coincidentally my brother phoned last night--an older friend has congestive heart failure. He knew nothing about palliative care, which I realize may be harder to explain than to write about. So I sent links to my 2 blog posts. (Since he has ADD, he'll probably prefer the NPR audio.) You might check it out if you haven't listened to it.

    THANKS for following my blog and best of luck with yours. You're off to a great start.

  2. Thank YOU Susan! I have so many things to share that hopefully will help someone going through this process. Hopefully it helps someone going through this for the first time. Losing a parent is hard but there can be so many wonderful things that happen in the process. I actually heard the NPR piece you mentioned while driving to a doctors appointment. It was a great perspective on dying. It was disturbing though in other ways as the guest was from the Johns Hopkins palliative care department. My mother was treated at JHU and palliative care (or even hospice) was never mentioned so many patients are falling through the cracks of the program. Another reason that I hope this blog helps bring the topic up with caregivers, patients and physicians.

  3. NPR's "All Things Considered" aired this last month and I put it in my "Of Current Interest" sidebar-- or click: Nothing about JHU was mentioned. I'd be interested in knowing when the program you heard aired? Maybe I can find it. Thanks

  4. Hmmm... I will have to go listen to this one then. I will look up when I was going to the doctor and that should give us some reference. I think it was around October.

  5. Found the program -- here you go!

  6. Such important concepts for dying well.
    Marcy Westerling