Managing EOL symptoms can be highly complex. Palliative-care practitioners also can help families make difficult decisions on such issues as the patient’s code status or whether to use a feeding tube. When a patient nears death, the goal of care changes from cure to comfort, and relieving symptoms is one of the most valuable contributions healthcare professionals can offer.
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(See How much time does the patient have left? by clicking the PDF above) From cure to comfort Although palliative care was recognized as a specialty in 2006, specially trained practitioners are still relatively few. What’s more, not all patients can access palliative-care specialists in early stages of chronic illness. Many patients and healthcare providers aren’t aware palliative care can ease symptoms they mistakenly assume it’s the same thing as terminal or hospice care. Yet all too often, palliative care isn’t used until the patient reaches the brink of death. In a study of 151 lung cancer patients randomized to receive either standard or palliative care, palliative care enhanced quality of life and extended survival even though patients received less aggressive care. Early intervention with palliative care can lead to a better quality of life, improved sleep, less fatigue, and decreased pain-in turn, enhancing the patient’s sense of well-being. With patients who are at the end of life, palliative care, as with hospice care, means that curative options are discontinued except those that relieve symptoms (such as palliative chemotherapy). Other common end-of-life (EOL) symptoms include agitation and delirium, anxiety, fatigue, weakness, constipation, nausea, and vomiting. For cancer patients, pain may predominate. For those in heart failure, for instance, dyspnea from fluid retention may cause agony. Author Guidelines and Manuscript SubmissionĪs death approaches, many patients with chronic illnesses experience uncomfortable signs and symptoms.
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