Wednesday, August 24, 2011

Accepting Palliative Care

The death of Canadian politician Jack Layton has reminded us how aggressive cancer can be. Sadly, it still claims many lives. When people are at the end of their life, they would likely benefit from palliative care - often called hospice care. This was a piece I wrote for my website and I think it bears repeating here:

When living with a chronic illness that will lead to death or a fatal disease, the time comes when you may be told that you should consider receiving palliative care.

Shock and Distress

People with chronic or fatal illnesses often live in hope that something can be done to prolong life, if not cure it, even if they do know that this isn’t realistic. When confronted with the idea of palliative care and what this care means, it can be shocking and distressing, because it drives home the point that life won’t be prolonged and that they can’t be cured. In fact, they may feel as if their doctor has given up.

This feeling may be particularly strong when children are involved. It may not be easy for parents to decide on accepting palliative care for their child, feeling as if they have somehow failed in their role as parents.

Transition to Palliative Care

The idea of palliative care shouldn’t come as a shock. If someone has a fatal or chronic illness, or is deteriorating to the point that end-of-life care is being considered by the healthcare staff, the subject should be brought up long before the transition is made.

Proper preparation is the key in a smooth transition from active treatment to comfort care. The patients and their families must come to grips with their new reality of palliative care and they have to be open and willing to accept it for the care to be of any benefit to them.

Unfortunately, the awareness of the need for palliative care isn’t always obvious to the doctors who are still actively treating dying patients because the whole idea of end-of-life care is still fairly new. While a doctor may still be in the “save the patient” mode, he or she may be reluctant to think about palliative care for the patient.

Agreeing to Palliative Care

Once a patient has agreed to transfer to palliative care, they are able to benefit from their services. But, it’s not unusual for someone who has accepted the idea of the care to become resistant or question the need again once they are receiving the end-of-life services. At this point, it’s important for the team to understand and to be able to work with the patient and the family as they go though this phase.

Family and Friends

An issue that may come up when patients enter palliative care is the difficulty that some family members and friends may have with the decision. While the patient may be ready and accepting of the end-of-life, family and friends may not be. The palliative care team is there for not only the patients under their care, but their family and friends too. They can help by talking to them, providing information, and being a shoulder for them to lean on.