Palliative Care

Teamwork gathers family, community and medical professionals for the good of the patient.

Written by Melissa Bean Sterzick

Palliative care is an approach to serious illness that focuses on quality of life, defining health care goals and gathering the patient’s community. Torrance Memorial’s interdisciplinary palliative care team is made up of registered nurses, licensed clinical social workers, licensed vocational nurses, chaplains, medical assistants, nurse practitioners and physicians. The palliative care team works closely with the nursing staff, specialists, primary care physicians, social services, dietitians, pharmacies and many other important resources for patients and their families.

What is palliative care?

Treatment for an advanced illness is a more complex scenario than treatment for a minor illness or injury. This is where palliative care is beneficial. A serious health condition creates more than just physical symptoms and the need for medication and surgery. It also has to be addressed in terms of its practical and emotional impacts on the patient and family.

Ujjwala Dheeriya, MD, is board-certified in palliative care and hospice and internal medicine by the American Board of Internal Medicine. With 24 years of experience, she is the medical director for palliative care and hospice for the Torrance Memorial Health System. She is dedicated to optimizing quality of life for her patients through building compassionate relationships with them and their families.

“What palliative care provides is specialized medical care for people living with a serious illness. It’s focused on providing relief from the symptoms and stress,” says Dr. Dheeriya. “The care team acts as a consultant and collaborates with primary care, hospitalists and other specialists.”

Even though more people are taking advantage of palliative care, many still misunderstand its purpose. Palliative care is not end-of-life care. It can be provided at any stage of an illness alongside curative treatment.

Who is a candidate for palliative care?

A hospital or physician will recommend palliative care if the patient or the patient’s family are experiencing distress. Advanced disease and dysfunction of major organs are the most common health issues related to the need for palliative care. Many patients served by a palliative care team have advanced cancer, advanced dementia, heart failure, advanced pulmonary disease, kidney failure or neurological diseases.

Frequent hospitalizations and office visits, progressive weight loss, uncontrolled pain or other symptoms such as nausea, shortness of breath, immobility, high dependence on caregivers, and concerns about caregiver mental health are all important reasons to seek support from palliative care.

Some palliative care patients will transition in and out of care throughout their disease. Whatever the scenario, those with serious ongoing illnesses can benefit from treatment applied holistically, addressing the many areas of their lives affected by their conditions.

How does it work?

Palliative care provides physical, logistical and emotional support for patients and their caregivers. The patient’s medical team coordinates care through frequent communication and regularly scheduled meetings.

Treatment begins with setting goals. Palliative care providers take their time with patient evaluations, listening to their needs and priorities to create a health care plan aligning treatment with intentions.

The medical team assesses the patient’s physical, emotional and spiritual needs and addresses symptoms, all while identifying where the patient would benefit from therapeutic intervention.

“All hospice care is palliative, but not all palliative care is hospice,” Dr. Dheeriya says. “Palliative care is offered alongside disease-modifying treatment and includes care for the patient’s pain and symptoms and the entire family’s psychological and spiritual distress.”

What are the benefits?

Easing physical pain and treating symptoms are essential aspects of palliative care. In addition, managing a serious illness can be a challenge, so palliative care providers use their expertise to simplify the workload. They compile medical information and empower the patient by streamlining communication and ensuring family members are partners in the treatment.

Much of what the palliative care team does is unite the patient, family and community to bring in appropriate resources—from equipment to arrangements for transportation, home health aides and food delivery.

If the patient has specific language needs, the team can connect the patient with practitioners who speak the patient’s language. If a patient is experiencing spiritual or existential distress, a chaplain can visit. The team can also seek members of the patient’s spiritual community to provide support or arrange for counseling for individuals or the family. Integrative health modalities such as mindfulness practices, aromatherapy and acupuncture are supported and encouraged.

How is palliative care different from hospice?

Palliative care is offered in a clinic, at home, or in the hospital, nursing home or extended care facility and is provided by a team of health care providers. Available at any stage of a serious illness, it focuses on symptom management during treatment and support for family members.

Hospice is intended for patients with a terminal illness who have an anticipated life expectancy of six months or less. Hospice can be offered in the home or a nursing home setting. Its main focus is keeping the patient comfortable to allow peaceful transition.

It’s important to make a distinction between the two for many reasons, but the most important is hospice is end-of-life care while palliative care can be provided during any stage of a disease regardless of expected outcome.