Palliative care offers invaluable support and clinical management for patients and their families. Most people don't realize that palliative care can be provided by hospice or palliative medicine professionals but by primary care providers. In 2006, hospice and palliative medicine was recognized as separate medical subspecialty. However, many health care professionals have misconceptions about palliative treatment. This can make it difficult to ensure that patients receive the best palliative and end-of-life care. Patients will choose comfort-focused care if their physicians are proactive in discussing end-of-life issues. They also receive care that is more aligned to their values and goals. This article explains palliative and hospice care. It also debunks common myths about palliative and hospice care. Finally, it offers suggestions for primary care providers on how they can incorporate palliative into their practices.
Abbreviations & Acronyms:
CPR (cardiopulmonary rescue), EOL (end-of-life), HPM (hospice, palliative medicine), PCP [primary care provider]
CME Activity
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Credit Statement The Mayo Clinic College of Medicine and Science has granted this journal-based CME activity a maximum of 1.0 AMA PRA Category 1 Credit(s). TM Physicians may claim only the credit commensurate to their participation in the activity.
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Learning Objectives You should be able (1) to identify the benefits of primary palliative and hospice care for patients, families, and caregivers; (2) to distinguish between hospice and palliative; (3) to give examples of common misconceptions or barriers regarding palliative and hospice care.
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William L. Lanier, Jr. MD, Terry L. Jopke, Kimberly D. Sankey, Nicki M. Smith, MPA have editorial and administrative control over the program's content, but they have no financial relationships with the industry.
The authors have no competing interests.
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Date Of Release: 2/1/2017
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What is Palliative Care?
Palliative care, unlike other medical specialties, does not treat the underlying cause of the disease. Palliative care treats symptoms to improve the patient's feelings, regardless of cause. The Center to Advance Palliative Care defines palliative care as: Palliative medicine is specialized medical treatment for patients with serious illnesses. It provides relief from symptoms and stress caused by serious illnesses, regardless of the diagnosis. It aims to improve the quality of life for the patient and their family.
1 To fully meet the needs of patients or their families, specialty palliative medicine uses an interdisciplinary team. Along with physicians, nurse practitioners, social workers, pharmacists, and chaplains all work together to address the psychosocial and spiritual needs of patients and their families. Symptom management, psychosocial-spiritual support, and facilitation of medical decision-making are 3 key domains of palliative care. The Table outlines the common elements of palliative medicine in each of these areas. Despite the rapid growth over the past two decades, including the recognition of palliative and hospice medicine (HPM), as an American Board of Medical Subspecialties, and the American Osteopathic Association's official subspecialties, there is still a shortage of HPM specialists. This will only increase with the aging population.
2 Therefore, the majority of palliative care should be provided by non-HPM professionals, such as internal medicine and family physicians and nurse practitioners.
3 Primary palliative care is best delivered by primary care providers (PCPs). The creation of team-based primary care such as the patient-centered hospital home is a key component.
4 The integration of population health principles in primary care restructuring should lead to improved outcomes for palliative care.
Sources:
https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care
https://www.sciencedirect.com/science/article/pii/S0025619616307637
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