What is palliative care?
Palliative care is specialized medical care for people living with serious illnesses. It is a form of team-based care focused on improving someone’s quality of life, offering support and relief for the physical, emotional, social, and even spiritual side effects associated with illness.
As palliative care and hospice are so often confused, Baylor Scott & White recognizes two distinct types of palliative care: supportive palliative care (SPC) and hospice care.
The difference between palliative care and hospice
Distinguishing the two types of palliative care is important. While both types of care are team-based services focused on improving quality of life for patients and their families, supportive palliative care can be provided alongside curative treatments, such as chemotherapy.
This supportive type of palliative care may be provided for many months (and sometimes even years) if people are referred early. Early referral has been shown to improve survival in some types of illnesses, including Stage IV cancers that have spread, known as metastatic cancers. Supportive palliative care may be provided in the clinic, in the community or the hospital.
Hospice requires that people discontinue treatments intended to prolong their lives. Even though hospice care can be available for the last six months of someone’s life, it is often not accessed until the final few months or weeks of life. Most hospice care is provided in someone’s home or a nursing home.
Why might I need palliative care?
The goal of palliative care, whether the supportive type or hospice type, is to improve the quality of life for people and their families who are facing serious illnesses. Both types of palliative care have been shown to improve discomfort, depression, anxiety, spiritual distress and other burdens of serious illness.
Early supportive palliative care, offered alongside treatments aimed at slowing or reversing serious illness, has been linked to improved survival, particularly in people with metastatic cancer. The American Society of Clinical Oncology recommends that people with Stage IV cancer begin receiving palliative care services within eight weeks of their diagnosis.
What services are provided by palliative care?
Palliative care (supportive or hospice) works in coordination with your primary treatment team to improve communication and coordination of care along with other important tasks, including:
- Complex symptom management, such as pain, shortness of breath, anxiety, loss of appetite and fatigue
- Prognostication, the process of predicting the likely course of a condition
- Advanced care planning
Who provides palliative care?
Your core SPC team at Baylor Scott & White can consist of the following key disciplines:
- Physicians
- Advance practice nurses or physician assistants
- Social workers
- Chaplains
- Child life specialists
Together, your SPC team works with you, your primary treatment team and your loved ones to ensure that you receive the best possible care and support, addressing all aspects of your physical, emotional and practical needs.
Where can I receive palliative care?
Palliative care can be provided in different locations based on your needs, ensuring you receive the right care in the most convenient setting, which may include:
- At home
- Hospitals
- Outpatient clinics
- Nursing homes
- Assisted living facilities
What does palliative care provide?
Palliative care focuses on improving the physical, emotional, social and spiritual symptoms associated with advanced illness. The services support both the person living with the condition, as well as their family and loved ones.
Supportive palliative care can benefit everyone involved in your care. Research has shown that people who receive supportive palliative care experience more overall satisfaction with their care and lower rates of depression and anxiety.
Palliative care can also help you plan for the future. Your team can assist with advance directives that allow you to specify your wishes if you are ever unable to speak for yourself.
Symptom management
Supportive palliative care professionals have specific training and expertise in managing symptoms of advanced illness such as pain, nausea, fatigue, depression and anxiety. In addition to prescribing drugs and other medical interventions for these symptoms, they can teach you coping strategies and techniques that you can incorporate into your daily life to help manage stress and improve comfort.
Education and advocacy
Your SPC team plays a key role in helping you understand your condition and how it may affect your life in the future. They take the time to explain your diagnosis, discuss potential changes to your health and provide a clear picture of what to expect moving forward. They can guide you in exploring all your treatment options, help you weigh the pros and cons of different approaches, and support you in deciding which path is best for your personal values, goals and preferences.
With their expertise, your supportive palliative care team ensures you are well-informed and can make decisions that reflect your priorities. They also serve as advocates, helping communicate your wishes, goals and preferences to other healthcare providers. This ensures that your entire care team is on the same page and provides care that is tailored to your needs and preferences, allowing you to make the most informed choices for your health and well-being.
Social support
Supportive palliative care team members can help build a support system for both you and your caregivers. Caring for someone with a serious illness can be stressful, and palliative care teams can help reduce some of that stress.
Your team can connect you with support groups, community resources and offer counseling for your family. They may also be able to help organize friends and family to assist with everyday tasks like picking up prescriptions or getting to appointments.
Whether the condition affects you, your child, parent, spouse or another loved one, supportive palliative care can provide the support needed to navigate the challenges of illness.
Spiritual support
Supportive palliative care includes spiritual support tailored to your beliefs and preferences. For many, connecting with a chaplain, religious leader, or spiritual advisor can be an essential part of coping with the emotional and psychological aspects of a serious illness. These regular visits offer a space for reflection, comfort and guidance as you process the impact of your condition on your life.
Spiritual care in palliative care isn't just about emotional support; it can also play a key role in shaping your treatment decisions. Your spiritual advisor may help you explore your values, guiding you toward making decisions that align with your personal beliefs and sense of purpose, ensuring your care reflects your medical and spiritual needs.
Financial and legal support
Members of your care team, usually the social worker, can connect you with resources to help ease the legal and financial burdens that come with having a serious illness. They can assist with decision-making related to:
- Costs: Palliative care can help you understand the resources available to cover medical expenses, including insurance coverage. Your team can also refer you to financial advisors to help with long-term planning and managing costs.
- Living arrangements: Whether you plan to stay at home, move in with a loved one or require care in an assisted living facility or nursing home, supportive palliative care can help you explore your options and make informed decisions about your living situation during your illness.
- Legal documents: SPC can help you prepare a living will, medical power of attorney, or other legal documents often needed in the setting of serious illness.
By addressing these practical concerns, palliative care helps reduce the stress of managing a serious illness, so you and your loved ones can focus on what matters most.
Frequently asked questions
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Who pays for palliative care?
Palliative care is a recognized medical specialty and supportive palliative care is typically paid for by private insurance, Medicare, Medicaid or the Veterans’ Administration. Checking with your insurer about palliative care coverage before you need it can help you be prepared for when it does become necessary. Medicare has a specific hospice benefit to cover the costs of hospice care.
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Does Medicare cover supportive palliative care?
Yes, Medicare covers supportive palliative care, just like it covers any other specialty.
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Is palliative care the same as hospice care?
No. Palliative care and hospice are not the same and are often confused. While both types of care are team-based services focused on improving quality of life for a person and their family, supportive palliative care can be provided alongside treatments, such as chemotherapy.
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When should someone be offered palliative care?
Supportive palliative care is recommended early in the course of serious illness. For example, it is recommended as soon as possible following a diagnosis of metastatic cancer. Supportive palliative care should be considered when the patient has specific needs related to physical, emotional, social or spiritual challenges of their serious illness, and/or when the patient needs additional support, information and focused advance care planning.
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Does using palliative care mean that I’m dying?
No, being referred to supportive palliative care doesn’t mean you’re dying. Palliative care can occur alongside treatment and is not the same as hospice care, which occurs at the end of life. Supportive palliative care can be provided at any stage of illness to slow, delay or treat someone’s condition.