Kelly Bastian, FNP-C, Managing Director, Agape Healthcare
What if you could have a skilled medical practitioner devoted to helping you live your best possible life in the midst of or beyond cancer treatment? And what if, instead of having to trek to a doctor’s office, this provider came to you in the comfort of your own home?
Palliative (pal-lee-uh-tive) care is a medical specialty offering this (and more) for people living with chronic or serious illness. The palliative care team, made up of a physician, nurse practitioner and often a social worker, partner with a patient’s other providers, serving as a central communication point and an additional layer of care.
People often equate palliative care with hospice. While hospice provides specialized care and support for people with a presumed prognosis of six months or less to live, palliative care is for anyone at any stage of illness, helping them to live as well as possible in the midst of (or beyond) treatment. And it starts with a question: What’s important to you?
Defining Your Life
Following a referral from a patient’s provider, the Nurse Practitioner (NP) meets with the patient and family. They discuss a patient’s history, overall condition, concerns and goals of care. Palliative care begins with the idea that the patient can best determine what she needs and what makes for a good life.
Patients often wish to continue working at their jobs or doing everyday things: walking the dog, cooking, shopping, enjoying a meal or getting out for a drink with friends. They may wish to travel or accomplish personal goals.
The next question, “What’s keeping you from achieving the life you want?” informs the next step: creating a plan.
You: Feeling Better
Palliative care typically begins with symptom management: addressing anxiety, depression, constipation, nausea, pain or a combination of conditions keeping people from fully living their lives. The palliative NP understands how to treat a person’s pain and symptoms and adjust to changing needs. If a patient knows she’s had nausea on days three and four of past treatments, the NP can adjust visits and care to address those symptoms. If a patient experiences new symptoms, or old ones return, the NP responds, making adjustments or additions to manage them as quickly as possible.
Support at Crossroads
Patients may find themselves at crossroads, having to make decisions about treatment or moving forward with their lives. Even a person with a strong support network can feel isolated or overwhelmed with the weight of this process. The palliative NP is experienced and skilled at helping a person understand the disease process, decisions and potential outcomes, supporting her through the process. Additionally, patients may see a palliative social worker who can address emotional, social, spiritual or practical issues around living with or beyond cancer. The social worker also connects families with resources for practical or other support to help along the way.
One of patients’ top concerns is how their disease or illness impacts the people closest to them. Palliative care helps people understand and talk about their illness better and provides family with support, tools and information.
A disease may not be curable, but it can be manageable.A disease may not be curable, but it can be manageable. When patients feel better, they live better (and their families feel better). When they are in control, they can plan, having meaningful time with people they love and accomplish things that are important to them.
Georgina, the wife of a palliative patient living with lung cancer, summed the art of palliative care, saying: “Oncologists treat cancer, cardiologists the heart. But what happens to the rest of you? Palliative care can be the facilitator for all to work together for the common good of the whole person.”
If you or someone in your life could benefit from this whole-person care, don’t hesitate to talk to your physician or get in touch with a palliative provider. Palliative care can help patients live their best possible life from the initial diagnosis through treatment and beyond.