What exactly is palliative care?

  1. Today I interviewed in a 12 bed onc unit with 6 of the beds being palliative care. From my background in hospice, I was under the impression that it is strict sympton management w/o aggressive treatment. Today at the interview, the nurse mgr. told me that palliative care can still receive chemo?I asked her if it was to debulk tumors for comfort and she said no, it's because the family wants it. I am very confused. Anyone?
    •  
  2. 11 Comments

  3. by   memphispanda
    Palliative care is providing comfort measures. It does not require a 6 month prognosis. Comfort measures can be anything that helps the patient feel better--even if it is just an emotional thing. Some people think hospice is giving up because they are no longer actively trying to cure the disease. Palliative care allows the quest for a cure to continue, while still addressing that most of what is boing done is just to keep the patient comfortable.
  4. by   purplemania
    the chemo is given to "treat" the family who are hoping for a miracle.
  5. by   BRANDY LPN
    Not sure if this is right, but I think I read somewhere that chemo can actually reduce pain in end stage CA. Anyone know if that is true?
  6. by   adrienurse
    Chemotx is an acceptable treatment in Palliative care for symptom control. No, it is not given with a hope of cure. TPN and blood administration are alse acceptable.
  7. by   leslie :-D
    Quote from adrienurse
    Chemotx is an acceptable treatment in Palliative care for symptom control. No, it is not given with a hope of cure. TPN and blood administration are alse acceptable.
    thanks guys although some of it is still rather ambiguous. adrien, do you have any links/references for me to check out? and given the horrific s.e.'s of chemo, how could it provide comfort? and if someone has let's say, m.s., then they would be eligible for the palliative care benefit to provide emotional and physical relief or does the dx have to be terminal?
  8. by   adrienurse
    I don't actually work on a Palliative Care unit, but there is one in my facility (and I'm a big fan of their work). Two places on the web that I can direct you to, to answer some or your questions are (just google them) the Victoria Hospice Society and the Canadian Virtual Hospice website.
  9. by   txspadequeenRN
    I do work in hospice and I can tell you that it has been my experience that if the family wants it they get it. I personally dont see the need for chemo (in a hospice situation) because of the other side effects that go with chemo vomiting ,feeling like crap etc etc. Im not sure about the use of chemo to reduce pain but I have given my weight 10x over in morphine .There is one item however I do not understand related to hospice , you do not have to be a DNR. Go figure, whats the point.....



    Quote from earle58
    Today I interviewed in a 12 bed onc unit with 6 of the beds being palliative care. From my background in hospice, I was under the impression that it is strict sympton management w/o aggressive treatment. Today at the interview, the nurse mgr. told me that palliative care can still receive chemo?I asked her if it was to debulk tumors for comfort and she said no, it's because the family wants it. I am very confused. Anyone?
  10. by   leslie :-D
    Quote from memphispanda
    Palliative care is providing comfort measures. It does not require a 6 month prognosis. Comfort measures can be anything that helps the patient feel better--even if it is just an emotional thing. Some people think hospice is giving up because they are no longer actively trying to cure the disease. Palliative care allows the quest for a cure to continue, while still addressing that most of what is boing done is just to keep the patient comfortable.
    thank you panda...."allows the quest for a cure to continue"...that's exactly what i was looking for. so does this mean palliative care is not restricted to cancers? would end stage copd or heart failure pts. be eligible for the palliative care benefit?

    leslie
  11. by   memphispanda
    Our palliative care team will work with any patient who has a end stage diagnosis, regardless of what the diagnosis is. The problem is getting the docs to use more palliative care consults instead of trying to do it all themselves. I guess maybe different places work it differently from seeing the other comments, but I know our palliative care patients can still receive potentially curative treatments (although really at this point it's just hoping for a miracle). They also aren't required to be a DNR although eventually most of them are DNR. Patients that are in hospice care are required to be DNR and not receiving curative treatment.
  12. by   julieK
    Chemo can be palliative if it keeps the tumor from growing or reduces it in size - this will ultimately reduce the amount of pain.

    -Julie
  13. by   Guppy
    I work in a HIV/AIDS Hospice in Canada and sometimes our clients and families request interventions that we might not agree with but it gives them some semblence of control...However it has to be done with the clients permission and many discussions happen before they get to end-of-life as to their wishes. I guess my advice would be to be clear on what the clients wishes are and have honest discussions with the families that the tx is not going to extend the loved ones life. Good Luck

close