Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on preventing and providing relief from the symptoms, pain, and stress of the illness. The goal is to improve quality of life for both the patient and the family. Palliative care may be initiated when the illness is diagnosed and continue throughout treatment, during follow-up, and at the end of life. Palliative care is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

Palliative care is whole-person and family-centered care that relieves symptoms of a disease or disorder, whether or not it can be cured. Hospice is a specific type of palliative care for people who likely have six months or less to live. Hospice care is always palliative care, but not all palliative care is hospice care.

Both palliative care and hospice care seek to improve the quality of life for both the patient and family. But palliative care can begin at diagnosis and continue along with treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.

Resources:

Some Differences Between Hospice Care and Palliative Care - NIH
Palliative and Hospice Care: What’s the Difference

Palliative care is appropriate for anyone with a serious illness. Serious illnesses may include cancer, dementia, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), end stage renal disease, liver disease, ALS, HIV/AIDS, and others. Palliative care is for people of any age and at any stage in an illness, whether that illness is curable, chronic, or life-threatening.

Resources:

How palliative care can help with more than 20 different diseases – Get Palliative Care

It is recommended that palliative services begin early in your illness.  Recent cancer guidelines say that cancer patients should receive palliative care early and together with their other treatments.  People who are newly diagnosed with advanced cancer should receive a palliative care consult within 8 weeks of their diagnosis.

Palliative care can be received in any setting, but it is not available in all areas.  Many patients begin receiving palliative care while in the hospital.  Others receive palliative care in their home, in a community clinic, in a cancer center, while in rehab, or in a skilled nursing facility.  More and more, palliative care is available outside of the hospital, in the home or a community setting.

Comprehensive palliative care is provided by a team of specially-trained professionals, who specialize in ways to assist patients and their families through what can be the most difficult time in their lives.  Members of the team typically include physicians, nurse practitioners, social workers, and spiritual care coordinators.  Some palliative care teams have physical and speech therapists, pharmacists, dieticians, and trained volunteers.

Palliative care teams are specialists who work together with you, your family, and your other doctors. They provide an extra layer of support when you need it most.  In addition to treating your symptoms and stress and supporting you and your family, the palliative care team communicates with all of your doctors so that everyone is on the same page.

• Helping you and your loved ones better understand your disease and diagnosis;
• Helping clarify the patient’s treatment goals and options;
• Assisting the patient and family with making medical decisions;
• Facilitating the development of advance directives;
• Helping the patient tolerate medical treatments;
• Relieving the patient’s symptoms and distress. Symptoms may include pain, depression,
  shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping, and anxiety.
• Supporting the patient’s ability to cope with the illness;
• Supporting caregivers and loved ones.
• Coordinating with the patient’s other doctors.

When speaking to your doctor about a referral for palliative care, be sure to ask about payment for palliative care services. Check with your carrier or health plan to find out what is covered, what is not covered, and whether you are responsible for co-pays, out-of-pocket costs or other charges. Ask about your responsibility for fees and request a fee schedule before agreeing to receive services.

Many private insurance plans, as well as Medicare and Medicaid, cover palliative care services in the hospital, in rehabilitation, and in skilled nursing or hospice facilities. Medicare and Medicaid don’t use the word “palliative” but the services are the same. There is no standard Medicare benefit for comprehensive palliative care as there is for hospice care. Payment for community-based palliative care varies by provider and insurance plan.

Some private health insurance plans provide some coverage for palliative care as part of their hospice, long-term care, or chronic-care benefits. If you own a long-term care policy, there may be palliative care benefits provided by that policy. Check with your health insurance or long-term care insurance representative.

Resources:

Why Some Patients Aren’t Getting Palliative Care – PEW Trusts

Research supports the efficacy of a palliative care approach in improvement of a patient's quality of life. Appropriately engaging palliative care providers as a part of patient care improves overall symptom control, quality of life, and family satisfaction of care while reducing overall healthcare costs.

Research outcomes regarding the implementation of palliative care programs include:

• Recent studies, including one published in the New England Journal of Medicine, have shown that patients with a serious illness who received palliative care lived longer than those who did not receive this care.
• Research indicates that providing palliative care in tandem with standard oncologic care among patients with advanced cancer is associated with lower rates of depression, increased quality of life, and increased length of survival compared to those receiving standard oncologic care.
• There is evidence that palliative care services increase the likelihood of dying in the patient’s preferred environment, and reduce symptom-burden without increasing caregiver stress.

For specific information in your area, consult your doctor or call your local hospital or hospice. Many hospices now offer palliative care programs.