Palliative Care Begins at Diagnosis, Not at End of Life

When most people hear the words palliative care, they immediately think about hospice or end-of-life care. This includes most medical professionals.This is understandable since palliative care was born out of the hospice movement.¹ However, palliative care is different from hospice care and should be implemented when patients early in a cancer diagnosis.

Palliative care is an approach that improves the quality of life of patients and their families who are living with severe illness.

What is palliative care? Palliative care is an approach that improves the quality of life of patients and their families who are living with severe illness. Palliative care prevents and alleviates physical, psychological and spiritual suffering through the early identification, correct assessment and treatment of pain and other problems.² 

Misconceptions About Palliative Care

There are several misconceptions that medical professionals, patients and their caregivers hold about palliative care. These misconceptions are a barrier to implementing palliative care which, in turn, can negatively impact the cancer journey for patients and their families.

Myth: Palliative care means the patient is dying.

Fact: Patients receive the most benefit from palliative care when it is implemented in the early stage of an illness. Palliative care is provided for a wide range of chronic diseases, such as cancer, COPD, diabetes, and heart disease. Cancer ranks second as the disease most in need of palliative care.²

Myth: Palliative care shortens a patient’s life span.

Fact: There is no evidence that implementing palliative care early in a diagnosis shortens survival. In fact, research indicates longer survival with the early integration of palliative care.³

Myth: The goal of palliative care is to relieve pain.

Fact: The goal of palliative care is to improve overall quality of life through a holistic approach to care that focuses on relieving symptoms and reducing stress. Palliative care includes the needs and well-being of the patient, caregivers and family members.

Myth: Palliative care can only be provided by certified palliative care professionals.

Fact: While palliative care is a medical specialty, most palliative care is provided by the primary medical team – nurses and doctors. Palliative care activities include communication, medical decision-making, symptom management, and psychosocial and spiritual support.

When and Why to Provide Palliative Care

The American Society of Clinical Oncology recommends that people with cancer receive palliative care as early in their diagnosis as possible. When palliative care is provided early, people with cancer tend to have a better quality of life, enhanced mental health, faster recovery and increased survival rates. Research has shown that palliative care helps patients adhere to their treatment plan and reduces the financial burden of care. Additionally, it strengthens coping skills and enhances human dignity. Every study conducted on palliative care report that it improved quality of life for patients and their families.^3,4 

What You Can Do to Improve Patients’ Lives

Patients often see nurses as the main point person for their diagnosis as they have more frequent contact with them than their oncologist. Nurses are in a unique position to address the varied needs of patients and their families as studies indicate that nurses are the most common interventionists for palliative care.³ Here’s what you can do to integrate palliative care into your practice:

• Ensure you have a clear understanding of palliative care and how it differs from hospice care. When palliative care is equated with end-of-life care, patients miss out on the benefits palliative care offers during their cancer journey.
• Educate patients, caregivers and their families about palliative care, so they understand that it goes hand-in-hand with curative treatment.
• Acknowledge when clients show signs of depression, anxiety or fear. Discussing emotional needs can open the door to referrals for mental health counseling or medication management.
• Recognize that spiritual beliefs come into play for cancer patients. Whether a patient finds comfort in their faith or questions their beliefs, acknowledging their spirituality can help them find peace or acceptance of their situation.
• Communicate with caregivers about their concerns and needs. Referring them to appropriate support resources can help alleviate caregiver stress.

According to the World Health Organization, palliative care is clearly recognized under the human right to health.² By integrating palliative care early in a cancer diagnosis, you can make a direct difference in patients’ quality of life during their cancer experience.

References

1. Sheikh M, Sekaran S, Kochhar H, Khan AT, Gupta I, Mago A, Maskey U, Marzban S. Hospice vs Palliative care: A comprehensive review for primary care physician. J Family Med Prim Care. 2022 Aug;11(8):4168-4173. doi: 10.4103/jfmpc.jfmpc_2262_21. Epub 2022 Aug 30. PMID: 36352983; PMCID: PMC9638637.
2. https://www.who.int/health-topics/palliative-care
3. Wantonoro W, Suryaningsih EK, Anita DC, Nguyen TV. Palliative Care: A Concept Analysis Review. SAGE Open Nursing. 2022;8. doi:10.1177/23779608221117379
4. https://www.medicalnewstoday.com/articles/palliative-care-vs-hospice