Palliative Care – Patients and Families
When patients were surveyed about the type of healthcare they want to receive when facing a serious illness, they overwhelmingly want:
- To be respected as a unique individual
- To be in control of their decisions and the direction of their care
- To avoid being a burden on loved ones
- To strengthen their relationships with loved ones
- Adequate pain and symptom management
- Their spiritual and cultural beliefs addressed
- To avoid inappropriate prolongation of dying
- Close communication between themselves, their family and healthcare professionals.
All of these key patient wishes are encompassed in palliative care.
Our Palliative Care Program is provided by a team of professionals, including physicians, nurses, social workers, and others as needed, in consultation with patients and their families. The three key pillars of palliative care include:
- Advance care planning
- Pain and symptom management
- Caregiver support.
The primary goals of the care team are to prevent or relieve pain and su ering, and to enhance the patient’s quality of life.
Palliative care involves assisting the patient and their family in making difficult medical decisions by holding conversations about the patient’s values, beliefs and personal goals for the care they receive. Patients and their families are encouraged to discuss their individual values and priorities, which are considered along with the type of illness. These values, beliefs and goals for care will guide the choice of treatment and specific interventions.
Making medical decisions can be difficult. It is important to ask yourself and your care team the following questions:
- Will the treatment make a difference?
- Do the burdens of treatment outweigh the benefits?
- Is there hope for recovery? If so, what will life be like?
- What do I value? What is important? What is the goal for my medical care?
Palliative care services are delivered using a collaborative and communicative process. Palliative care delivery involves the patient, family, physicians and healthcare team all working together to ensure that the patient experiences care that is compassionate, supportive, comforting and reflect his or her goals.
Palliative care is not the same as hospice care. Palliative care may be provided at any point during a person’s illness, even right from the time of diagnosis. Palliative care may be given at the same time as typical treatments. Palliative care is appropriate at any age, at any stage of disease and along with any other type of treatment a patient may be receiving.
Hospice care is palliative care at the end of life. To enter the hospice program, a person’s life expectancy must be six months or less, and they must make a commitment to forgo usual and customary treatments for their underlying disease.
For more information please visit www.getpalliativecare.org
Advance Directives
Illness or injury can happen at any time. Do your family members or friends know your healthcare wishes? Would they know what to do? Does your doctor know what treatments you do or do not want?
With advance directives, you can make sure you get the care you want. You will feel reassured knowing that your choices can be honored immediately, without losing valuable time, and that difficult decisions will be easier for your loved ones to make.
Every time you go to a medical facility someone will ask you if you have an advance directive. Advance directives can be several different forms:
- Health Care Proxy – This form designates other people to make medical decisions for you if you are ever unable to make them for yourself.
- Living Will – This document identifies your wishes should you ever be critically ill.
- Do Not Resuscitate (DNR) – This document is used for individuals who have decided that in the event their breathing or heart stops, they would not like heroic measures to be performed to attempt to restart their lungs or heart.
- Medical Orders for Life-Sustaining Treatment (MOLST) – This document is the least known.
For copies of the forms or for more information regarding planning for a serious illness, please visit the following websites:
www.compassionandsupport.org
www.sharingyourwishes.org
www.theconversationproject.org
What is an Advanced Directive?
Advanced Directives tell your healthcare providers about your wishes if you are unable to speak for yourself. This can be information about care that you would like to receive or what you do not want to have done.
There are two main types of Advanced Directives. They are the Healthcare Proxy and the Living Will.
What are your rights relating to your healthcare?
As a competent adult you have the right to:
- Receive information from your doctor to make informed decisions about a procedure or course of treatment. Your doctor should review the risks and benefits that are being proposed, possible side effects and alternatives.
- Decide to accept, reject or discontinue medical care and treatment.
- Refuse medical treatment, even treatment necessary to sustain life. The refusal of life-sustaining treatment is not considered suicide or assisted suicide.
- Appoint a proxy to make decisions for you in the event that you are unable to make decisions for yourself.
- Appoint a proxy to make decisions as you would have made them, or if your wishes are not known, make decisions in your best interest.
Do I have to have an Advanced Directive?
No, it’s your decision. You will be admitted and treated upon admission to the hospital. A healthcare provider may not condition your care or discriminate on the basis of whether you have executed such a document.
Can I have more than one Advanced Directive?
Yes. It is possible to have a Healthcare Proxy and a Living Will.
What is a DNR?
A DNR is a Do Not Resuscitate order. This is another type of Advanced Directive. This means that you would not have CPR or Cardiopulmonary Resuscitation performed if your heart and breathing stopped. You would not be placed on any type of ventilator to help you breathe.
A DNR is only discussed with you and/or your healthcare agent if the medical condition is such that there is no chance of recovery. Keep in mind that a DNR is totally independent of a Health Care Proxy. These two Advanced Directives are NOT the same.
