What is palliative care?
Comfort care; End of life - palliative care; Hospice - palliative carePalliative care helps people with serious illnesses feel better by preventing or treating symptoms and side effects of disease and treatment.
Understanding Palliative Care
The goal of palliative care is to help people with serious illnesses feel better. It prevents or treats symptoms and side effects of disease and treatment. Palliative care also treats emotional, social, practical, and spiritual problems that illnesses can bring up. When the person feels better in these areas, they have an improved quality of life.
Palliative care can be given at the same time as treatments meant to cure or treat the disease. Palliative care may be given when the illness is diagnosed, throughout treatment, during follow-up, and at the end of life.
Palliative care may be offered for people with illnesses, such as:
-
Cancer
Cancer
Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
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Lung diseases
Lung diseases
Lung disease is any problem in the lungs that prevents the lungs from working properly. There are three main types of lung disease:Airway diseases -...
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Kidney failure
Kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
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Dementia
Dementia
Dementia is a loss of brain function that occurs with certain diseases. It affects one or more brain functions such as memory, thinking, language, j...
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HIV/AIDS
HIV/AIDS
Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...
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Amyotrophic lateral sclerosis (ALS)
Amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis, or ALS, is a disease of the nerve cells in the brain, brain stem and spinal cord that control voluntary muscle movemen...
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While receiving palliative care, people can remain under the care of their regular health care provider and still receive treatment for their disease.
Who Gives Palliative Care?
Any provider can give palliative care. But some providers specialize in it. Palliative care may be given by:
- A team of doctors
- Nurses and nurse practitioners
- Physician assistants
- Registered dietitians
- Social workers
- Psychologists
- Massage therapists
- Chaplains
Palliative care may be offered by hospitals, home care agencies, cancer centers, and long-term care facilities. Your provider or hospital can give you the names of palliative care specialists near you.
The Difference Between Palliative Care and Hospice
Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.
Hospice care is most often offered only when the person is expected to live 6 months or less.
What Does Palliative Care Include?
A serious illness affects more than just the body. It touches all areas of a person's life, as well as lives of that person's family members. Palliative care can address these effects of a person's illness.
Physical problems. Symptoms or side effects include:
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Pain
Pain
When you have a serious illness, you may have pain. No one can look at you and know how much pain you have. Only you can feel and describe your pai...
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-
Shortness of breath
Shortness of breath
Someone who is very ill may have trouble breathing or feel as if they are not getting enough air. This condition is called shortness of breath. The...
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Loss of appetite, and feeling sick to the stomach
Loss of appetite, and feeling sick to t...
People who have a very serious illness or who are dying often don't feel like eating. Body systems that manage fluids and food may change at this ti...
Treatments may include:
- Medicine
- Nutritional guidance
- Physical therapy
- Occupational therapy
- Integrative therapies
Emotional, social, and coping problems. Patients and their families face stress during illness that can lead to fear, anxiety, hopelessness, or depression. Family members may take on care giving, even if they also have jobs and other duties.
Treatments may include:
- Counseling
- Support groups
- Family meetings
- Referrals to mental health providers
Practical problems. Some of the problems brought on by illness are practical, such as money- or job-related problems, insurance questions, and legal issues. A palliative care team may:
- Explain complex medical forms or help families understand treatment choices
- Provide or refer families to financial counseling
- Help connect you to resources for transportation or housing
Spiritual issues. When people are challenged by illness, they may look for meaning or question their faith. A palliative care team may help patients and families explore their beliefs and values so they can move toward acceptance and peace.
Learning More
Tell your provider what bothers and concerns you most, and what issues are most important to you. Give your provider a copy of your living will or health care proxy.
Ask your provider what palliative care services are available to you. Palliative care is almost always covered by health insurance, including Medicare or Medicaid. If you do not have health insurance, talk to a social worker or the hospital's financial counselor.
Learn about your choices. Read about advance directives, deciding about treatment that prolongs life, and choosing not to have CPR (do not resuscitate orders).
Advance directives
When you are very ill or injured, you may not be able to make health care choices for yourself. If you are unable to speak for yourself, your health...
Treatment that prolongs life
Sometimes after injury or a long illness, the main organs of the body no longer work properly without support. Your health care provider may tell yo...
Do not resuscitate orders
A do-not-resuscitate order, or DNR order, is a medical order written by a health care provider. It instructs providers not to do CPR (cardiopulmonar...
References
Arnold RM, Kutner JS. Palliative care. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 3.
Desai S. Palliative care. In: Anderson CC, Kapoor S, Mark TE, eds. Harriet Lane Handbook, The. 23rd ed. Philadelphia, PA: Elsevier; 2024:chap 23.
Lee KA, McGuire H, Reville B, Abrahm JL. Palliative care. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 100.
Rakel RE, Trinh TH. Care of the dying patient. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 5.
Review Date: 2/8/2024
Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.