Palliative Care
What Is Palliative Care?
When we "palliate" an illness, we focus on easing its pain and discomfort. For example, when a child has a cough, she or he might get "curative" care to battle the infection, and palliative care to treat the symptoms of the cough and help him or her feel better. Antibiotics are curative; offering cough medicine or a humidifier is palliative.
For breast cancer survivors, palliative care can make a significant contribution to your sense of well-being and comfort, allowing you to do as much as possible each day by limiting the impact of the disease on your daily life and activities.
Palliative care can be used in conjunction with chemotherapy to make the patient a lot more comfortable. If you'd like to learn more about palliative care options, talk with your physician or ask for a referral to a palliative care specialist, depending on what's appropriate for your stage of cancer.
How Do Palliative Care and Hospice Work?
Hospice care offers resources and opportunities for cancer patients and their family and friends. Many experts in palliative care are associated with hospice programs because hospices focus on providing palliative care. Hospice staff has an understanding of what people go through when a family member is ill. They can help manage pain and articulate, with the family, the goals of treatment and reduce anxiety by addressing end-of-life issues. The decision to include hospice care brings the possibility of using an interdisciplinary team of professionals. You could ask a social worker to visit once a week or a chaplain to visit once a month along with the physician and the nurse. All support is equally available to family members.
When Do I Ask For Hospice Care?
Hospice is appropriate for late-stage cancer. Another point at which you may want to consider hospice is if you've been receiving palliative care as the focus of your treatment because the cancer has mot responded to other treatment.
How Do I Talk To My Doctor About Hospice?
Talking about the end of life isn't something that makes most of us comfortable and facing the truth can be difficult. For those reasons, patients and their physicians sometimes avoid the discussion. You may be afraid if you mention hospice to your doctor that he or she will think you're "giving up." On the other hand, your doctor may avoid talking to you about it out of concern that you may feel discouraged or give up hope.
Patients who bring up hospice with their physicians often say they wished they had done it sooner. They say it gives their families permission to talk about their illness in an open and honest way. When people are asked what they want at the end of their life, many say they want to be at home, not in pain, and surrounded by friends and family. Hospice and palliative care are a big part of making these wishes come true.
Writing an advance directive is a good idea before any late-stage treatment begins. An advance directive is a document you create in which you share your wishes about the medical care you would like now and in the future. The document will only be used if you cannot make the decisions yourself. Contact your state medical society for examples.
How Do I Choose a Hospice?
Discuss the subject with your doctor. Also, you may want to visit National Hospice and Palliative Care Organization at www.nhpco.org. Many states have organizations that provide a list of the hospices in your area. When you speak with hospice representatives, ask for references of families who have worked with them.
Excerpted from the Spring 2004 issue of Lifeline.
