Palliative Medicine

Question 1

define palliative care

Answer 1

1. The interdisciplinary care provided within HPM
   A. Nursing component
   B. Social Work component
   C. Spiritual Care collaboration when appropriate
2. A Philosophy of care
3. Expands traditional disease model of treatment
4. Supportive care delivered concurrently with disease modifying treatments
5. For any age, and at any stage of serious illness

Question 2

What is the goal of palliative care?

Answer 2

1. Goal is to improve quality of life for patients living with serious illness
   A. Treating “Total Pain”
   B. Address family/caregiver stressors

Question 3

What is included in total pain?

Answer 3

1. Physical
2. Psychological/emotional
3. Social
4. Spiritual/existential

Question 4

How is palliative care different from hospice care?

Answer 4

All hospice care is palliative care, but NOT all palliative care is hospice care.

Question 5

What is included in hospice care?

Answer 5

1. Prognosis dependent – “terminal” prognosis
2. Patients are NOT seeking aggressive measures
3. insurance benefit through Medicare (most 3rd party payors)

Question 6

What is included in palliative care?

Answer 6

1. NOT prognosis – dependent
2. CAN and SHOULD be provided alongside all other appropriate medical treatments that are aligned w/patient’s goals of care
3. Covered like any other consult service – based on time

Question 7

What is included in the palliative are integrative model for serious illness?

Answer 7

1. Life prolonging care
2. Palliative care
3. Hospice care
4. Bereavement

Question 8

What are the top priorities of pts with serious illness?

Answer 8

1. Adequate pain & symptom management
2. Avoidance of inappropriate prolongation of dying
3. Sense of control
4. Relief of burden on others/caregivers
5. Strengthening of relationships

Question 9

What does palliative care look like in practice?

Answer 9

1. Help to control pain and other distressing symptoms
2. Facilitate communication with patient/caregivers about goals of care – “difficult discussions”
3. Provides practical support for family/caregivers
4. Coordinates care and transitions across fragmented medical system
5. Attention to psychosocial stressors; anticipatory grief
6. Attention to spiritual/existential stressors