Palliative Care Relieves Symptoms, and Extends Lives

The evidence for the benefits of palliative care is growing. Palliative care is a comprehensive service that improves the quality of life for patients with serious illnesses. It helps patients receive adequate pain and symptom management, avoid inappropriate prolongation of dying, helps patients achieve a sense of control over their illness, as well as helps them make the most of their remaining time.  It is a consultative service where caregivers from various disciplines work together as a unit to consider the list of symptoms and needs of the patient, and then create a practical plan for addressing the physical, emotion, social, cultural,  and spiritual needs to the furthest extent possible. 

From an empathetic and economic perspective, palliative care makes sense; and now a new study shows that palliative care and end-of-life planning when offered early in the diagnosis helps cancer patients lead longer and better lives.  In the 3 year study, 151 patients with advance lung cancer received cancer treatment as well as palliative care.  These patients lived two months longer than those who received cancer treatment without palliative services, and showed marked improvement in overall quality of life.  The study was published in the Aug. 19 issue of the New England Journal of Medicine.

“We were surprised by the magnitude of impact that palliative care had on quality of life, which normally decreases over time in these cancer patients, and the magnitude of the impact it had on depression. The survival benefit was the most surprising thing. Cancer care and palliative care are not mutually exclusive. Providing both is not only feasible, but beneficial. “  Jennifer S. Temel, MD, oncologist at Massachusetts General Hospital (MGH) Cancer Center in Boston and co-author of the study. From: “Cancer Patients Live Longer With Palliative Care,” on WedMD, August 19, 2010. http://tinyurl.com/2arjtno

In fact, psychological and emotional assessments are extremely important in identifying feelings of anxiety, depression, loss of dignity, and helplessness that can result from patients facing or fearing lack of control. Psychological distress can have devastating consequences for the patient, including amplifying the intensity of pain and diminishing the ability to make appropriate treatment decisions.

Ideally, palliative care should begin at the time of diagnosis. However, only 75% of hospitals offer palliative care, it is often offered towards the final days of life, and many physicians fail to offer it to their patients at all, often due to a “rescue mentality” where death is seen as failure.  But palliative care can assist patients and their families in making better decisions about what is helpful and what is fruitless, and help make their time together a healing experience.  Patients and their families need to ask for these services from their physicians and local hospital systems.

“The mission statement of every health system I know is it provide the best care we possibly can to families and patients who will want to come back and see us again. Palliative care fits right in with the mission statement of every health system that I know.” - Thomas Smith, MD, FACP, Medical Director of the Thomas Palliative Care Program at the Virginia Commonwealth University Massey Cancer Center.

Physicians, nursing staff, chaplains, social workers, physical therapists…all those involved in the care of patients can benefit from training on how to provide physical, psychological, social, cultural and advance-care planning assessments; offer patient and family education; have crucial conversations regarding tough decisions; and learn the clinical symptoms of impending death.  Envision, Inc. has an award-winning video developed in conjunction with the Thomas Palliative Care Program, and is ideal for Veteran Affairs hospitals and other health care facilities wanting to improve their end-of-life programs.   For more information on the video, and to see a free preview prior to purchase, please visit  http://www.envisioninc.net/index.php/programs/details/to_care_always_quality_care_at_the_end_of_life/.

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