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KEY CONCEPTS

KEY CONCEPTS

  • Image not available. Palliative care may be provided to any patient with a serious illness, at any point in the course of the illness, including while a patient receives curative or disease-focused therapy.

  • Image not available. Hospice is a form of palliative care, which has been defined by Medicare to encompass care solely focused on comfort and quality of life during the last 6 months of a patient’s life.

  • Image not available. Pain is a common symptom among patients receiving palliative care and may be managed safely and effectively using nonopioid, adjuvant, and/or opioid therapies.

  • Image not available. Opioids are the drug of choice for the management of dyspnea.

  • Image not available. Constipation, nausea, vomiting, anxiety, and delirium are common symptoms among patients receiving palliative care and may be managed effectively with drug and nondrug therapies.

  • Image not available. End-of-life care can be provided to patients in the last days of their lives through palliative or hospice care, and provides management of common terminal symptoms.

  • Image not available. Identifying a patient’s goals and structuring care to achieve those goals is a key component of palliative care. Identifying a patient’s goals of care involves communication with patients, their families and/or caregivers, as well as other healthcare professionals.

  • Image not available. Addressing nonphysical needs, such as spirituality and faith, are key components of providing quality palliative care.

Image not available. Palliative care, or palliative medicine, is specialized care provided to patients with serious illness with a goal of managing symptoms and helping patients to cope with their illnesses.1 It is provided by an interdisciplinary team of healthcare professionals, including physicians, pharmacists, nurses, nurse practitioners, social workers, chaplains, and others.2 Palliative care is appropriate for any patient with a serious or potentially life-limiting illness, at any point during the time course of that illness. Common diseases for which palliative care is appropriate include cancer, heart failure, advanced lung disease such as chronic obstructive pulmonary disease (COPD), organ failure such as liver or renal failure, and neurologic diseases such as dementia and Parkinson disease.2 Patients may receive palliative care throughout the course of a serious illness, including while the patient receives treatment aimed at managing or curing the disease. If or when the serious illness progresses and disease-focused therapies are no longer helpful or desired, palliative care continues to be provided to manage symptoms and maximize quality of life.

Provision of palliative and hospice care to patients with limited prognoses has been shown to improve patient and caregiver satisfaction,3,4,5 reduce healthcare utilization,3,4 and decrease healthcare costs.3,4,6 In addition to providing symptom management, improving patient and caregiver satisfaction, and reducing healthcare costs, early integration of palliative care has been shown to increase survival among patients with advanced cancer.7,8

Because of the evidence supporting the benefits of palliative care, clinical practice guidelines for serious illnesses incorporate palliative care into treatment recommendations. The American Society of Clinical Oncology and National Comprehensive Cancer Network both recommend ...

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