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 September 20, 2006, issue of JAMA contains an article about spiritual issues in the care of dying patients. This Patient Page is adapted from one previously published in the March 16, 2005, 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 expenses
Creating a support network of people such as other family members, friends, and clergy can be very helpful.
Hospice Foundation of Americahttp://www.hospicefoundation.org
Family Caregiver Alliancehttp://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 8, 2006, 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, one on managing pain in the April 5, 2000, issue, and one on palliative sedation in the October 12, 2005, 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. To purchase bulk reprints, call 203/259-8724.
Stevens LM, Lynm C, Glass RM. Palliative Care. JAMA. 2006;296(11):1428. doi:10.1001/jama.296.11.1428