Transcription:
What is Palliative Care?

It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie Cole (Host): Many people mistakenly think that palliative care is the same as hospice care, and so they may be reluctant to seek advice about palliative care. However, it's such an important medical care that focuses on people who are seriously ill. It's meant to help patients get relief from their symptoms, pain and stress, whatever their diagnosis.

Welcome to Its Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And joining me, I'm so glad to have her here as another Melanie, Melanie Maki. She's a critical care nurse and the nurse navigator for the palliative care program at Henry Mayo Newhall Hospital.

Melanie, thank you so much. And I don't get to say that on my podcasts very often, but welcome, Melanie. I'm so glad you're here. And can you start by telling the listeners what is palliative medicine and care? Give us a little definition or evolution of it and how it differs from hospice care, which more people seem to have heard of.

Melanie Maki: Of course. And thank you for having me on. Palliative care is a patient-centered approach to care. It is a medical specialty that enhances the quality of life for both patients and their families who are faced with a serious or life-threatening or terminal illness. It consists of interdisciplinary team, a physician that is board-certified in palliative medicine, nurses, a chaplain, and a social worker.

So with palliative care, patients receive an additional layer of support in conjunction with curative treatment. So that's where the difference is. With palliative care, patients can continue to receive treatment for their disease, whether it's curative or palliative measures to make them comfortable, but they continue to have tests done.

With hospice, a doctor has determined that you have most likely less than six months to live and you forgo any kind of curative treatment and just kind of let nature take its course and control your symptoms and pain with medication management. So that's where the differences are. Palliative, you can continue care. Hospice, you forgo care.

Melanie Cole (Host): That was excellent. Very comprehensive answer. You explained it so well, Melanie. So who can benefit from palliative care? How long can they be on it? Speak about when it's appropriate to seek out palliative care and what might that look like.

Melanie Maki: So, you know, technically, you can begin palliative care at diagnosis. But, typically, it's good to ask yourself questions like have you been diagnosed with a serious life-threatening or terminal illness? Are the pain and symptoms that you're having from it unmanaged? Are you having a difficult time with side effects from the treatment that you're receiving? Do you find yourself having frequent hospitalizations, or you're being hospitalized with the same symptoms repeatedly? Do you find that when you're hospitalized, you're having an intensity of the services provided, things are getting a little more serious each time you're hospitalized? Are you having difficulty coping, emotionally or spiritually? Do your family and loved ones also need support? You're not sure what your options are or you just need assistance on advanced care planning. So these are all things you can ask yourself. And if you're answering yes to any of those, you could talk to your primary care physician about whether or not palliative care would be right for you because you do need a doctor's order for palliative care.

Melanie Cole (Host): So then, what type of treatments are used for palliative care? Tell us a little bit about how it works. You mentioned a few different providers, this multidisciplinary care team, so that even spiritual issues or depression, stress along with physical issues, which could be nausea or shortness of breath or any of these things, pain management. Speak about what treatments this is and how you use them.

Melanie Maki: The palliative care physician is in charge of managing your symptoms and your pain. For any nausea or vomiting, they might prescribe medications. There might be treatment options that can help alleviate the nausea and vomiting. If you're having shortness of breath, there are palliative measures that can be taken. For instance, let's say you have lung cancer and you have fluid building up around those pleural spaces around your lungs, you can have drains put in that help drain off that fluid that is causing pressure on your lungs, which then causes shortness of breath. So that's a palliative measure that can be done.

Maybe you have terminal cancer, but you can get radiation therapy on a tumor that is pressing on your spine and causing pain. So that's a palliative measure. And the palliative care doctor works in conjunction with the other physicians, the oncologists, the pulmonologists, the critical care doctors. They work together as a team to try and manage these symptoms.

Melanie Cole (Host): I think you just made one of the most important points of this podcast because people get afraid to get involved in palliative care, not only because of the confusion about hospice care, but because they think then that they don't get the curative care and that their doctors won't work with their curative team or, you know, the physicians that they've been working with. So they get to stay with the doctors they've been working with and even their primary care provider?

Melanie Maki: Right, right. It's an additional layer of support. So it's an addition to the team you already have in place.

Melanie Cole (Host): So while palliative care, Melanie, helps the patient with whatever the situation is, how does it also help the family members that are working with this patient, loving them, helping them to go through whatever they're going through?

Melanie Maki: So we have a team. We have social workers and a chaplain, so they can help provide spiritual and emotional support for the families. And also the palliative care nurse helps establish goals of care for the patient. So once you can sit down with the family and talk about what their understanding of the disease process is, what their understanding of their treatment options are, and what the patient and the family want for themselves as this disease progresses, you can develop a plan of care. And when you have a plan in place, it decreases the anxiety for families and patients.

When a patient is still alert and oriented and able to make their own decisions, it's a good time to let your family know what you want your plan to be. Because a time could come when you're not able to speak for yourself. And it's those times that really cause stress for the family and they struggle with what decision to make if they haven't had that conversation with you. And we find that families often don't have those conversations because they're difficult conversations to have. No one wants to imagine their life without their loved ones, so they just avoid the conversation altogether. And then when the time comes, the patient can't speak for themselves, the family doesn't know what to do, so they struggle or they disagree, you know? The children disagree. "Oh, mom wouldn't have wanted this," or "Mom would have wanted this." so. We help try and get in there early and get a plan in place so that that plan can happen the way that they all expect it to.

Melanie Cole (Host): Such great points. And what about for patients at home? Can you get palliative care if you're not in the hospital? Can you get it at home, however that would work?

Melanie Maki: There are outpatient palliative care services. I personally don't deal with them, so I don't really wanna speak to it too much, but they do exist. And you could ask your primary care physician, about getting an order for palliative care if you feel that you meet that criteria.

Melanie Cole (Host): This is important information. And Melanie, as we get ready to wrap up, what would you like to tell the listeners about palliative care and why it's such an important part of medical care? Because so many people get confused about it. But I'd like you to take this opportunity right now to tell people probably what you tell people every single day when you get these questions, what you want them to know about palliative care and the services available at Henry Mayo Newhall Hospital.

Melanie Maki: What I'd like to tell them is that palliative care improves the quality of life for the patient, so that they're better able to tolerate their medical treatments. The end of life is going to come for all of us someday. And if we have that opportunity to have that support in place and a plan in place that guides us through to that end, I think that it's most beneficial to improve a patient's quality of life when they're dealing with a serious or terminal illness.

Melanie Cole (Host): Thank you again, Melanie, for joining us today. And to learn about the palliative care program at Henry Mayo Newhall Hospital, go to henrymayo.com and type the word palliative in the search box at the top of the page and all the information that you need will be there. You can also visit our library at library.henrymayo.com for so much information on all kinds of care options available at Henry Mayo Newhall Hospital.

That concludes this episode of It's Your Health Radio. I'm Melanie Cole. Thanks so much for joining us.