Palliative care also benefits referring physicians and hospitals. Patient and family satisfaction increase, both with the attending physician and with the hospital care in general. Cost is decreased as goals are addressed and therapy that does not meet patient goals is discontinued. Bed capacity increases as patients are discharged to other appropriate places of care when discharge better meets the patient's goals. Lengthy discussions, family meetings and educational sessions can be handled by the palliative care team, freeing the primary physician to attend to other demands in the hospital, in clinic or in the operating room. Nursing staff satisfaction and retention increase when a palliative care program is active in a hospital. Also, palliative care helps hospitals meet standards for clinical quality and pain control.

What is palliative care and what does it do?
Palliative care is interdisciplinary care that works to relieve suffering and improve quality of life for patients with advanced illness and their families. Simply put, palliative care aims to relieve any kind of suffering, in any patient, in any family, in any clinical situation. Suffering can take many forms, from physical symptoms to existential distress, from emotional pain to family conflict. Palliative care works first to improve symptom control. Studies have shown that palliative care involvement reduces pain and also relieves nonpain symptoms, such as nausea, breathlessness, constipation, delirium and insomnia. A patient whose symptoms are closely monitored and treated is more able to complete curative and life-prolonging therapy or participate in life-closure activities, when comfort is the goal.

How is palliative care different from hospice?
Hospice care is provided through a Medicare benefit that allows for primarily home care of patients with a terminal illness. Patients must have a prognosis of less than 6 month and, in general, must forgo the most aggressive or curative treatments. Palliative care, on the other hand, is delivered along with all other appropriate medical care. There is no requirement to give up curative or life-prolonging therapy. Patients may continue dialysis, chemotherapy, transfusions and radiation therapy. There is no requirement for a terminal illness or an expected prognosis of six months or less. Anyone who is suffering can benefit from palliative care, even if they have many years yet to live. Palliative care intends to take the outstanding evidence-based symptom management and family support that hospice is known for and make it available to people who are suffering who do not yet qualify for hospice. In summary, palliative care is available to assist with everything from simple pain management in otherwise healthy patients, to care of the patient who is actively dying in the hospital. Patients may be pursuing curative or life-prolonging therapy, or may be searching for improved comfort and support at the end of life. Anyone with suffering qualifies for palliative care.

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