Palliative care is based on the philosophy of care for the “whole person.” An important goal of Palliative Care is to educate the patient and their family about death and dying.
Death is not the enemy, but rather an acceptable and expected outcome. The dying have an important role that is different than the “sick” role of expected recovery. In this role, the goal is not to prolong or shorten life, but to make End of Life care as comprehensive and important as the Beginning of Life.
Palliative Care is a new revolution, it insists on a return to the professional values of health care that have been long over looked in our modern time of emphasis on a medical-technical delivery of care. Societal expectations have been youth oriented, technology, cure, and life prolongation. With this type of care model, people stay in the “sick” role, rather than entering the dying role. In this role they most likely will or have received care and treatment designed for recovery that can, in some instances be painful, debilitating, costly, and repetitive while extending their life far beyond what the disease dictated.
Palliative care should begin at diagnosis, helping one to match their goals with their treatment. Improving quality of life using as few “targeted” medications as needed for symptoms that may arise. Palliative Care affirms life, providing a support system for relief of symptoms, physical, spiritual and psychological. Allowing a person to live as actively as possible until death.
The National Hospice and Palliative Care Organization (nhpco.org) has listed the following progressive, chronic, debilitating diseases that would benefit from this care model: Congestive Heart Failure, (CHF); Chronic Obstructive Pulmonary Disease (COPD); Alzheimers; Kidney Disease; Pulmonary Fibrosis; Parkinsons; Multiple Sclerosis; Cancer; Stroke. The word “cure” is not usually used when diagnosing and discussing these diseases. Palliative care conversations are less about what modern medicine “should” do and more about a plan of care to ease symptoms. Educating on what changes will happen, and what can be done to provide comfort and peace, allowing a person autonomy and dignity in their decisions.
Let us embrace this sub-speciality of medicine by educating ourselves, asking questions and having transparent conversations about end of life and death.