How Does Palliative Care Address Patient Needs?
Oct 30, 2015 03:07PM
By Hilary Daninhirsch
North Hills Monthly Magazine: What does palliative and supportive care actually mean?
Dr. Sumaiya Zaidi: Palliative medicine takes a multidisciplinary approach to very sick patients who are living with chronic and life-limiting diseases. We look at their whole being, taking into account their psychological, spiritual and existential well-being, and not just their physical needs. Palliative care has actually been here for decades, but people are now becoming more aware of it and learning how to utilize it.
NHMM: What is the goal of palliative care?
Zaidi: The goal is to make sure that people have a good quality of life; not just focusing on quantity, but ensuring that whatever time they have left, they’re comfortable, they’re where they want to be and their family is comfortable with the plan of care. We’re seeing more and more families request it for their loved ones; there is that shift in mindset.
NHMM: Is this different than hospice care?
Zaidi: Hospice care falls under the umbrella of palliative care. A palliative care clinician can see a patient right from the beginning when he or she is diagnosed and has symptoms, and is still seeking aggressive care to cure or slow the progress of their disease. Hospice comes at the end of life when someone has less than six months to live; when there are no more curative options and when the goal is to provide comfort care. The focus shifts to receiving aggressive, high-yield, low-burden care for their symptoms, especially if they want to be cared for wherever ‘home’ may be and if they would like to avoid hospital stays.
NHMM: What are the requirements for someone to qualify for palliative care?
Zaidi: For anyone who has a serious disease that is overwhelming, it is perfectly appropriate for them to see a palliative care physician. Palliative care can be used for multiple things, including symptom management. Oftentimes, people are sick and have debilitating symptoms. Providers trained in palliative care are very experienced in managing these symptoms. Sometimes you’re just supporting the individual who is ill and the family. It means being on that journey with patients and understanding that this is a very difficult process for families as well. When people are trying to make difficult end-of-life decisions, how they envision death to be—these are all good reasons to involve palliative care.
NHMM: How does palliative care focus on helping patients maintain quality of life?
Zaidi: Just realizing that people who are sick have spiritual and existential needs is a major consideration. People are worried about how their families will do. People who have a serious disease have a lot of anxiety or fears, and most often, they don’t talk about them. Sitting down with people and exploring their concerns is how we can begin to alleviate some of those issues.
NHMM: What do studies show about the benefits of having palliative care?
Zaidi: We do know that for people who have palliative care services, their symptoms are better controlled, and they feel that their quality of life is better. There was a study published in the New England Journal of Medicine in 2010 which showed that people with lung cancer who were randomized to receiving an early referral to a palliative care clinician lived longer, their symptoms were better managed and they perceived their quality of life to be better than those who were not. We know patients feel that they are really being helped when we take care of symptoms and address quality of life.
NHMM: Do you believe that this is a discipline of medicine that is going to continue to grow?
Zaidi: Yes, the need is constantly growing in the community. People are recognizing more and more how palliative care can be helpful, and families are seeking it out. Also, people are living longer; they have more serious illnesses now. We have an elderly population that is very frail. We are offering improvement to their quality of life. We are achieving comfort at end of life, and we are making sure families are supported and are being heard.