Monday Medical: Palliative care focuses on quality of life |

Monday Medical: Palliative care focuses on quality of life

Lindsey Reznicek
For Steamboat Pilot & Today

A serious medical diagnosis often brings with it a range of symptoms, pain and stress for a patient and their loved ones. That’s where palliative care can be beneficial.

“It used to be thought that palliative care was only for those who were dying, but over the last 30 years, palliative care has expanded to include any patient diagnosed with a serious illness, regardless of age or stage of illness,” said Dr. Sarah Gebauer, a palliative care physician at UCHealth Yampa Valley Medical Center. “The goal is to improve quality of life for both the patient and the family.”

What is it?

Palliative care is specialized medical care for people with serious illnesses. It is provided by a team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. And, it can be provided along with curative treatment.

There are two main components of palliative care: advanced care planning and symptom management.

Through advanced care planning, a patient’s wishes for their current and future care are outlined to ensure the patient and the family are on the same page.

“We talk through what different options mean from a medical standpoint and, at the same time, incorporate social work and spiritual care components into the care plan — it’s important to acknowledge those aspects, too,” Gebauer said. “We work to ensure the patient’s wishes are documented, as advanced care planning is beneficial for everyone involved.”

Common symptoms managed by palliative care providers include delirium, pain, shortness of breath and intractable nausea and vomiting, or nausea and vomiting that is difficult to control.

When should it be considered?

Any patient diagnosed with a serious or life-threatening illness can be seen by palliative care. According to Gebauer, there isn’t a point in a diagnosis where it’s ever too early or too late.

“Studies have shown increased life expectancy when palliative care is delivered alongside other medical care, likely due to improved symptom management by the palliative care team,” she said.

Who can benefit?

In the past 10-15 years, there has been a significant increase in the types of diagnoses seen by palliative care.

“Previously, patients with cancer were the only ones seeking palliative care,” Gebauer said. “Now, we’re also seeing patients with cardiac, pulmonary, neurologic, infectious disease, chronic complex and dementia-related diagnoses seek this care.”

Because very few people live in complete isolation, the involvement of a patient’s support network is considered essential.

“We want to improve the patient’s quality of life, and that includes making sure caregivers are taken care of, too,” Gebauer said. “If a caregiver is feeling burned out or unsupported, that doesn’t help in caring for the patient.”

How is palliative care different than hospice care?

There are a number of similarities with palliative care and hospice care, including comfort care, stress reduction, complex symptom relief related to serious illness and physical and psychosocial relief.

But there are many differences, too.

“While hospice care is typically for those with a life expectancy of six months or less, a patient can receive palliative care for years,” Gebauer said. “Palliative care is for those with a serious, life-threatening illness, whereas hospice is only for those with a terminal illness. Palliative care is for those seeking life-prolonging, curative treatment, while hospice is for patients who are not seeking curative treatment.”

Insurance can also be a differentiator.

“It’s important to remember that hospice is always palliative, but not all palliative care is hospice,” Gebauer said.

Anything to clarify about palliative care?

Gebauer has heard that people think palliative care means giving up or not receiving treatment. Nothing could be further from the truth.

“We are another advocate for the patient,” she said. “The integrated approach of this specialty allows us to connect with the patient’s primary care provider, other specialists and additional care providers, such as physical or occupational therapists or nurse case managers, to ensure every aspect of a patient’s health and well-being is incorporated into their care.”

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