Palliative care is rarely an easy topic to discuss. By its very definition it invokes the prospect of life ending. The Oxford Dictionary online defines it as “care for the terminally ill and their families, especially that provided by an organised health service”.
Advocacy group Palliative Care Australia (PCA) expands on this: “Palliative care is person and family centred care provided for a person with an active, progressive, advanced disease, who has little or no prospect of cure and who is expected to die, and for whom the primary goal is to optimise the quality of life.”
Naturally, we all want a dying loved one to have the best quality of life possible in their remaining time. But what if giving them the best chance of that quality means moving them into care earlier?
Such a prospect might seem counterintuitive, and confronting – not just for the patient, but their loved ones, too. Yet there is strong evidence to suggest that providing palliative care sooner improves patients’ quality of life and overall mood.
The case for earlier palliative care
Some may take a bit of convincing to embrace the idea of starting care earlier than expected. This is understandable, given the long-held societal view of what such care entails.
Dr Helen Senderovich, a care expert at the University of Toronto, sums up that view. “When people hear the words ‘palliative care’, they think ‘end-of-life care – I’m going to die’,” she said.
Such a description evokes thoughts of providing strong painkillers in a patient’s final days, and little else. And while that may once have been a valid description, palliative care has evolved into much more. It is now a multidisciplinary specialty, Dr Senderovich said. It encompasses the physical, psychological and spiritual needs of patients and their families throughout the trajectory of disease.
Several studies have shown that earlier implementation of such care not only improves quality of life but can reduce the length of hospital stays or the need to go to hospital at all. One study also showed that patients receiving early care lived an average of almost three months longer than those without.
In Australia
A significant number of Australians requiring this care are cancer patients. Cancer Council Australia (CCA) supports those studies. Its Understanding Palliative Care booklet says “there is no need to wait until you are close to the end of life. Research shows having palliative care early improves quality of life.”
The booklet also adds another important point – patients who take up palliative care won’t necessarily use it permanently.
“Depending on your needs, you may use palliative care from time to time, or you may use it regularly for a few weeks or months. Some people receive palliative care for several years.”
Ever-improving cancer treatments have driven this change. They can sometimes stop or slow the spread of advanced disease and relieve symptoms for a number of years. “The cancer may then be considered a chronic (long-lasting) disease,” CCA says.
The University of Melbourne has taken up the palliative care baton with an initiative called The Care Plus Study. It takes an evidence-driven approach to implementing standardised, timely care for people with cancer. It aims “to improve health outcomes and reduce acute hospitalisation at the end of life”.
The study says that quality palliative care provides a benefit to further reduce suffering, improve survival and care match patients’ preferences. It also reduces costs.
Palliative care remains a confronting proposition. But the evidence suggests that its earlier adoption can improve outcomes for all involved. It’s an option well worth considering, if and when the time comes.
Have you been confronted with the prospect of palliative care? What was your experience? Let us know via the comments section below.
Also read: Caring for a cancer condition that often goes unseen
Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.
