Objectives

• Increase understanding of Palliative Care services.
• State three basic focuses of Palliative Care.
• Promote collaboration between primary teams and Palliative Care.
• Increase understanding of varied use of Palliative Care.
• Discuss varied use of palliative care: YOU DON’T HAVE TO BE DYING. 

Palliative care focuses on(5):

• Reliving suffering.
• Achieving best possible quality of life.
• Patients and family needs.
• Assessment and treatment of symptoms.
• Support for decision making.
• Assistance with matching treatment with goals of care.
• Mobilization of resources.
• Collaboration with care providers.
• Maintaining goals of care especially when curative treatments are no longer beneficial.
• Supportive care when burdens of treatment exceed benefits.
• Providing compassionate comfort care in the last months to weeks of life.

Palliative care teams⁽⁴⁾

• Physician, social worker, nurse practitioner, dedicated chaplain, psychiatrist, nurses, pharmacist, and volunteers.
• No real “team” may have one dedicated employee.
• Physician or nurse practitioner only.
• Set consult team brought in for GOC and EOL.
• Large department with multiple rounding teams.
• Large department with all essential members under one umbrella.
• No palliative care team, consult hospice for in-patient care.

Common symptom management requests:

• Pain management
• Constipation
• Nausea and vomiting
• Anxiety/depression
• Establishing goals of care
• End of life care.

Benefits of palliative care⁽⁴⁾:

• Improved home care, leading to less ER visits.
• Improved patient, family, physician satisfaction.
• 54% fewer hospital admissions.
• 80% reduction in ICU days.
• 26% reduction in inpatient LOS (2 days).
• 52% decrease in clinic visits, 60% increase in hospice enrollment.
• Result: saving>$700 per member/month.

Promoting self-care⁽³⁾

• Additional focus is on each other
• Help to re-frame hope
• Help to not view death as a failure
• Acknowledge existence of professional grief
• Educate on difference between a normal dying process and suffering
• Staying in the present
• Give up thinking you have control over how a patient’s body will respond, instead focus on what you can do to make their remaining time compassionate and comfortable 
• Focus on the Journey.

It’s all about the Journey

We cannot change the fact a patient will become terminally ill or die, but we have everything to say about THE JOURNEY(3).

• Be pro-active and anticipate.
• Request palliative care consults.
• Celebrate the person - they are not their disease. 

palliative care