Some serious chronic medical illnesses, such as certain cancers or AIDS,
cause significant suffering and impair quality of life. Palliative care is therapy that focuses on decreasing pain and suffering
by providing treatments for relief of symptoms along with comfort and support
for patients of all ages. Palliative care uses a team approach that involves
the treating doctor, the family, and other health care professionals and social
services. Hospice care, which involves helping ill
individuals and their families during the last period of life, is often an
important part of palliative care.
The March 16, 2005, issue of JAMA contains
an article about how doctors, patients, and families can work together to
provide optimal palliative care. This Patient Page is adapted from one previously
published in the February 20, 2002, issue of JAMA.
Pain management is vital
for comfort and to reduce patients' distress. Health care professionals and
families can work together to identify the sources of pain and relieve them
with drugs and other therapies.
Symptom management involves
treating symptoms other than pain such as nausea, weakness, bowel and bladder
problems, mental confusion, fatigue, and difficulty breathing.
Emotional and spiritual support is vital for both the patient and family in dealing with the stresses
of critical illness.
Health care professionals can educate families
about the patient's problems and provide advice on care such as giving medication
and recognizing symptoms that require immediate medical attention.
Home support services may provide help with transportation,
shopping, and preparing meals.
Respite care provides
relief and time off to the caregiver.
Families may need help with developing a plan to
manage the financial strains of caregiving, such as loss of income and added
Creating a support network of people such as other
family members, friends, and clergy can be very helpful.
Hospice Foundation of America 800/854-3402 http://www.hospicefoundation.org
Family Caregiver Alliance 800/445-8106 http://www.caregiver.org
To find this and previous JAMA Patient Pages, go to the Patient Page
Index on JAMA's Web site at http://www.jama.com. A Patient Page on hospice care was published in the February 21, 2001,
issue, one on end-of-life care in the November 15, 2000, issue, one on the
stresses of being a caregiver in the December 15, 1999, issue, and one on
managing pain in the April 5, 2000, issue.
Sources: Americans for Better Care of the Dying, Beth Israel
Medical Center, Growth House Inc, Hospice Education Institute, Hospice Patients
Alliance, National Hospice Foundation, World Health Organization
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
Stevens LM, Lynm C, Glass RM. Palliative Care. JAMA. 2005;293(11):1410. doi:10.1001/jama.293.11.1410