Are You Missing out on Palliative Care?

Education | September 12, 2017 | by Kirsten Jacobs

Palliative care helps many Americans manage terminal illness and prepare for the end of life. But that’s not the only thing it can do.

You could be missing out on a groundbreaking approach to increasing independence, enhancing well-being, and improving quality of life among your residents and clients.

It’s called palliative care.

If you did a double-take on that last sentence, you’re not alone.

Many Americans see the words “palliative care” and immediately think of “hospice” and “end-of-life.”

That’s a shame, really.

Don’t get me wrong. Palliative care helps many Americans manage terminal illness and prepare for the end of life.

But that’s not the only thing palliative care can do.

It also can help ensure that people can live life to the fullest, even as they cope with serious chronic conditions like diabetes, arthritis, heart failure, Parkinson’s disease, and dementia.

What is Palliative Care?

Dr. Steven Pantilat, founding director of the Palliative Care Program at the University of California San Francisco, provides an interesting lens that helped me develop a much broader view of palliative care.

Pantilat focuses not so much on what palliative care is, but on how it is delivered.

Basically, says Pantilat, palliative care takes a step back. It doesn’t just look at the person’s health condition. Instead, the palliative care team focuses on the whole person.

Think for a minute about the implications of such an approach.

Palliative care acknowledges that each person is multifaceted and complex. That person’s identity is much bigger—and richer—than the chronic condition with which he or she is living.

The primary goal of palliative care, then, is to get to know the person, and only then to help the person develop a support system that he or she can use to manage a chronic condition and continue enjoying life, engaging in meaningful activities, and making decisions.

A Palliative Care Model for Chronic Disease

The philosophy of palliative care underpins the person-centered care models and wellness programs that many LeadingAge members currently implement. That puts these organizations in a great position to expand their missions by making palliative care an “essential service” for every person who is living with a life-changing chronic condition.

Here’s a way to start:

  • Give residents or clients access to an interdisciplinary care team that can help them manage their chronic conditions. The team might consist of health care professionals, direct caregivers, social workers, psychologists, pharmacists, family members, and others.
  • Teach team members how to ask probing questions that will help them discover each person’s values and life goals.
  • Train team members to work with one another, and with the person, to develop a life-giving plan based on those goals and values.
  • Encourage the team to be creative in helping each person manage chronic conditions and quality of life.

Many Models, Many Choices

Because it is person-directed, the palliative care model will differ from one community to the next and, at its best, from one person to another. Not all residents and clients will have the same goals or hold the same values. So, it makes perfect sense that their palliative care plans will not look alike.

That’s what I love about palliative care. It invites us to discover the limitless pathways that can bring comfort, hope and self-direction to people with chronic conditions.

Maybe a palliative care plan will take a pharmacological approach to managing the person’s pain. But the plan could just as easily feature acupuncture, massage, yoga and meditation.

Mental health counseling or spiritual supports may be what the person is seeking. Or he or she may find ample comfort in the ability to make daily decisions about when and what to eat, even if those choices don’t reflect the team’s idea of healthy living.

Any of these options could be combined with a tailored wellness program reflecting the person’s choice to exercise, eat a healthy diet, or spend time socializing, volunteering, pursuing hobbies or having fun.

Empowerment Care

Palliative care isn’t just a way to usher someone into the next life. It’s also a way to empower a person to live as fully as possible while they are still with us.

I know a lot of people with chronic conditions who could benefit immensely from this approach. Don’t you?

Resources to Help You

Want to learn more about palliative care? I recommend the following resources:

  • A conversation with Dr. Steven Pantilat about why palliative care must become an “essential service” for all.
  • A 2010 The New York Times article about the “Comfort First” initiative at Beatitudes Campus, a LeadingAge member in Phoenix, AZ. This palliative care approach puts the comfort of residents with dementia above all else, even if that means allowing residents to dine at 2 a.m., eat all the chocolate they want, or take an alcoholic “nip at night.”