nurse and man reading
nurse and man reading
nurse and man reading

What Is Palliative Care Medicine?

Facing a serious disease or condition can create physical, emotional and spiritual suffering. Palliative medicine is compassionate care combined with evidence-based approaches that can improve your quality of life or that of your loved one.

Palliative care addresses physical symptoms of the disease itself, side effects of treatment, and stress and uncertainty about the future. These interventions can allow you more freedom to do the things that are important to you and live with more comfort and peace of mind.

Engaging a palliative care team can give you access to expertise in nursing, pain management, respiratory therapy, chaplaincy, nutrition, pharmacology, social work and other disciplines.

Knowing your priorities, goals, culture and lifestyle helps palliative care providers incorporate what is important to you into your medical care.

Do I (or does my loved one) need palliative treatment?

Palliative care medicine can help those living with conditions such as, but not limited to:

  • Cancer
  • Chronic obstructive pulmonary disease (COPD/emphysema)
  • Organ disease or failure (heart, kidneys, liver or immune system)
  • Neurologic disease such as dementia, Huntington’s disease, progressive multiple sclerosis, Parkinson’s disease, stroke or tremor
  • HIV/AIDS

How does palliative care help me or my loved one?

Palliative care medicine puts the patient at the center of each plan and recommendation. With that in mind, palliative care experts start by learning about you, your diagnosis and how an illness and its treatment are affecting your well-being. To formulate a care plan, palliative experts talk to you to gauge your concerns and goals, and work with you on strategies for achieving them.

The palliative team may also collaborate with your other doctors for additional insight into the course of your illness and the impact of its symptoms and treatment.

What does it mean to be under the treatment of palliative care?

If you are under the treatment of palliative care, it means you have a specialized team that is helping you or your loved one with the following:

Communication and care coordination. When you or someone you care about is seriously ill, getting (and understanding) the information you need, scheduling appointments and being ready for what comes next can be overwhelming. The team helps you coordinate information flow between doctors, nurses, family members and others and access resources to keep track of appointments, tests, paperwork and prescriptions.

Pain control. Pain is one of the most feared symptoms of any disease and, understandably, a concern for many patients and their loved ones. The palliative team can customize a strategy for pain relief:

  • A palliative pain relief program may start with medicines such as ibuprofen and acetaminophen and add helper drugs (such as steroids or muscle relaxers) or stronger medications such as opiates.
  • Surgery may be a possibility if it can increase a person’s comfort or mobility.
  • Complementary therapies for pain relief may also be suggested, and can include massage therapy, relaxation methods, music therapy, acupuncture and aromatherapy.

Symptom management. Many chronic and progressive diseases cause distressing symptoms. Palliative care medicine can lessen the impact of many symptoms, including:

  • Reduced mobility
  • Fatigue
  • Insomnia
  • Gastrointestinal issues such as nausea, vomiting or diarrhea
  • Breathing difficulties
  • Anxiety and depression

Nutrition. Nutritionists and dietitians working in a palliative framework can assess your nutrition and offer counseling. They can help find options for sustaining nourishment that consider your dietary needs, your ability to eat and digest, and your personal and cultural preferences.

Emotional and spiritual well-being. Serious illness can cause fear, anger, confusion, grief and sadness that can add to physical suffering. Patients and their families may feel exhausted, anxious or alone. Navigating these difficult emotions is easier with support from palliative practitioners who can offer comfort, spiritual resources and safe spaces for the range of feelings associated with illness. If desired, they can assist in decision-making and planning associated with the end of life, so patients can ensure their goals are achieved.

When is it time for palliative care medicine?

A common misconception about palliative care medicine is that it is solely for people at the end of life. In fact, palliative care medicine can provide relief and comfort at any stage of serious illness — you don’t have to wait until the final stages of progressive or terminal disease. You can continue other medical treatment while receiving palliative care.

Where does palliative care medicine take place?

Palliative care medicine meets people wherever they are, including:

  • In the hospital (intensive care units, surgical and medical units, children’s centers and emergency departments)
  • Specialty treatment settings such as cancer care centers
  • Residential nursing care facilities
  • At home — some palliative medicine programs offer visiting health care providers who can provide in-home treatment

How do I get palliative care?

The first step is to speak with the health care provider who is treating you and explain what is most important in order to improve your quality of life — this may be aggressive pain management, the ability to be treated at home, or something else entirely. Your health care provider can refer you to a palliative care service program. 

Most insurance plans, including Medicare and Medicaid, cover at least some palliative care services. A social worker from the palliative care program can help with questions you have.

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Johns Hopkins Palliative Medicine Program

At Johns Hopkins, our multidisciplinary team of palliative care specialists is comprised of physicians, advanced practice providers, nurses, pharmacists, chaplains, child life experts and social workers. Together the team provides compassionate specialized medical care to improve quality of life for patients and their families as they cope with illness.