By Perry Farmer
and Barbara Ebling
It's January, and families are facing some serious decisions about quality of life.
For some, it may mean something as simple as a new gym membership. For others, the decision is far more serious. Many are looking for ways to ease the pain of a terminally ill family member through a regimen of palliative care.
This year, more physicians will be doing advanced care planning. If you have Medicare, your doctor will now be reimbursed for an appointment to discuss the type of life you want when ill.
Palliative care may be part of that conversation. This is medical care that aims to relieve patients of the symptoms, pain, and stresses of advanced illness - whatever the diagnosis. The goal is to improve quality of life and relieve suffering for both patient and family. Palliative care is appropriate at any age and at any stage in an advanced illness, and curative treatment doesn't have to stop.
Palliative care is predicated on the patient making choices and knowing the factors of his or her disease, and its symptoms, trajectory, and prognosis. During the conversation, your physician explains the disease, the types of treatment available, their success rates and side effects, the impact on quality of life, and the documents needed to ensure wishes are clearly stated. (These documents include advance directives, health-care power of attorney, and physician orders for life-sustaining treatment.)
"Palliative care is not about giving up," said Tim Ihrig, a physician and the medical director for palliative care at Trinity Regional Medical Center in Iowa. "In fact, studies with cancer patients show that those who receive true palliative care have less depression, undergo less chemotherapy, spend less time in the hospital, have a higher quality of life, and eventually are more likely to die at home on hospice. In addition, they live longer than without true palliative care."
He added: "Palliative care puts the patient in the center of the health-care hub, encouraging the patient to call the shots on the goals of care and intensity of care - exemplifying true informed consent."
Most of us prefer to be in the driver's seat when dealing with a serious disease like cancer, cardiac disease, amyotrophic lateral sclerosis, or HIV/AIDs.
We all need to educate ourselves on palliative care. Not all physicians are familiar with it. Certainly not all doctors focus their attention on it or have a board certification in the specialty. You may need to search to find the right doctor with whom to have that talk mentioned earlier.
Some hospices have palliative-care programs. Make sure that the one you contact has board-certified palliative-care physicians and staff, and that the program is distinct from hospice. Not all hospices work this way.
You can learn more about hospice vs. palliative care online. Or check out Ihrig's TED Talk. He's a national expert on the topic and has helped design palliative-care programs across the country.
Perry Farmer is the founder and president of Crossroads Hospice and Palliative Care. firstname.lastname@example.org
Barbara Ebling, Crossroads' executive director, is based in Plymouth Meeting.barbara.ebling