Palliative care is a type of care that provides physical, emotional, social and spiritual support for people with cancer and their families.
Many people have doubts or fears about palliative care because they don’t understand what it is and then fear what they think it means. People often think of palliative care as care that is limited to the last few days or weeks of life – but that is only a small but important part of palliative care. You may even think that if you have palliative care, death comes faster – but in fact, research shows that palliative care can help people live longer.
Palliative care doesn’t mean that doctors are giving up. It means that the focus of care changes from trying to cure the cancer to:
- keeping your quality of life as much as possible
- relieving your symptoms like pain or shortness of breath
- making you as comfortable as possible
- providing support during this time, which may be months or years
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For some people with advanced cancer and their families, staying at home for as long as possible, even to the end of life, is very important. Being cared for at home can be very comforting, but it does mean more responsibilities for loved ones who are caregivers. Talk to your healthcare team about what it means for you to stay at home so that everyone understands what they need to do.
You may be able to arrange for palliative care services in your home. Home care nurses, health aides, respite workers and volunteers can be a part of your home palliative care team.
You may need to make changes so that your home is comfortable and safe. This can be as simple as removing a rug that someone might trip over or as major as adding wheelchair ramps or renting a hospital-style bed. Speak to a social worker or another member of the healthcare team if you need help figuring out what changes you need to make.
Even with the right support in place, there may come a time when it’s no longer possible for a person with advanced cancer to stay at home. You may need medical care and support that family members can’t provide. It’s important to recognize that moving to a hospice or palliative unit isn’t a failure on anyone’s part. Family members can still offer love and support to someone in a hospice or hospital, while having skilled care from the healthcare team.
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Some healthcare facilities provide palliative care and support. These include pain or palliative care clinics, palliative care units in hospitals, long-term care facilities and hospices.
A palliative care clinic is a clinic where people can receive pain and symptom management as well as emotional and practical support. It’s set up for outpatients, which means you don’t sleep or stay there.
A palliative care unit is where people can receive specialized palliative care in a hospital setting. It’s for inpatients, which means you stay and sleep there. Most palliative care units provide care in the last months or weeks of life, but some acute palliative care units are set up for short stays to manage symptoms.
A hospice facility or program offers supportive care for people at the end of life as well as their families. Hospice volunteers can provide support in the home, and residential hospices are places where people with cancer can be cared for at the end of life in a homelike setting.
Hospices and palliative care units have specific admission criteria, and there are often waiting lists. It’s a good idea to fill out an application early, with the help of your healthcare team. You may want to apply to a palliative care facility even if you are hoping to stay at home, as a back-up plan for your care.
A long-term care facility is where people live to get help with medical and personal care when they can no longer live by themselves. A nursing home and assisted living housing are types of long-term care facilities.
Esper P . Principles and issues in palliative care. Yarbro, CH, Wujcki D, & Holmes Gobel B. (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 74: pp. 1815-1828.
Paice JA . Care during the final days of life. Yarbro, CH, Wujcki D, & Holmes Gobel B. (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 75: pp. 1829-1842.