Palliative Care Key Facts
“Palliative care (is) one of the fastest-growing fields in medicine.”
HealthCare Chaplaincy is a thought leader for quality, accessible and affordable palliative care.
Q: What is palliative care and how can it help you?
A: The World Health Organization (WHO) definition is: “Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”
Palliative care encompasses the whole person – body, mind, and spirit. It’s appropriate when receiving treatment intended to cure, for when an illness is chronic, or near end of life. Palliative care relieves suffering and matches treatment to what the patient and family choose based on knowing and understanding what those choices are.
Q: When can you receive palliative care?
A: You can receive palliative care at any stage of a serious illness, whether it is potentially curable, chronic or life-threatening.
Click here for a visual presentation of the modern palliative care spectrum.
Q: Isn’t palliative care the same as hospice care?
A: No. You can receive palliative care at any stage of a serious illness, whether that illness is potentially curable, chronic or life-threatening. Hospice is a type of palliative care for people who likely have six months or less to live. In other words, hospice care is always palliative, but not all palliative care is hospice care.
Q: Who is on the palliative care team?
A: Physicians, nurses, professional chaplains, social workers, and others.
Q: How many U.S. hospitals offer palliative care?
A:80% of U.S. hospitals with more than 300 beds, which is where most people with complex or serious illness find themselves, now have a palliative care program.
(Source: Diane Meier, MD, Director, Center to Advance Palliative Care)
1455 hospitals report having a palliative care program, a 130% increase from 2000.
(Source: National Palliative Care Research Center 2009)
Q: What is the connection between palliative care and chaplains?
A: Palliative care is attentive to the needs of the whole person – body, mind, and spirit. So, too, is chaplaincy care. As members of the palliative care team, professional chaplains assist patients and families in difficult circumstances to find meaning and bring them comfort.
A 2009 consensus conference of more than 50 physicians, nurses, professional chaplains, social workers, professors, and university level researchers sponsored by the Archstone Foundation concluded that:
- Spirituality supports the best possible quality of life for patients and their families.
- A board certified professional chaplain should be the spiritual care professional on the palliative care team.
In addition: The new (2013) edition of Clinical Practice Guidelines for Quality Palliative Care issued by the National Consensus Project for Quality Palliative Care states that ideally the interdisciplinary palliative care team should include a board certified, professional chaplain and that spirituality is a “fundamental aspect of compassionate, patient and family centered care that honors the dignity of all persons.”
This formal statement about professional chaplains and expanded guidelines about spiritual, religious, and existential aspects of care represent's a major recognition by the professional palliative care field about the role of each.
HealthCare Chaplaincy consultants, the Reverends George Handzo and Sue Wintz, contributed significantly to the development of the spiritual and chaplaincy care guidelines, and their recommendations were adopted verbatim in almost all cases. HealthCare Chaplaincy is one of 40 organizations that have endorsed the guidelines (see partial list below), and will be applying them throughout its clinical practice and research and education programs.
These guidelines were created by the National Consensus Project for Quality Palliative Care, whose members are the American Academy of Hospice and Palliative Medicine, Center to Advance Palliative Care, Hospice and Palliative Nurses Association, National Association of Social Workers, National Hospice and Palliative Care Organization, and the National Palliative Care Research Center.
The guidelines were announced at the March annual conference of the American Academy of Hospice and Palliative Care Medicine by National Consensus Project co-chairs, Diane E. Meier, MD, FACP, director of the Center to Advance Palliative Care and Betty Ferrell, PhD, RN, FAAN, FPCN, research scientist at City of Hope.
At the announcement, Dr. Ferrell stated emphatically, “Quality palliative care includes all eight domains (areas of care). If you are not providing excellent spiritual care, you are not providing palliative care.”
Dr. Meier said, “The new palliative care guidelines encourage discipline-specific certification for each of the major disciplines in a palliative care program, even for chaplaincy.”
40 organizations have endorsed these Guidelines. Besides the member organizations
listed above and HealthCare Chaplaincy, these include:
American Academy of Nursing
American Academy of Pediatrics
American Association of Colleges of Nursing
American Association of Colleges of Pharmacy
American College of Surgeons
American Geriatrics Society
Association for Clinical Pastoral Education
Association of Professional Chaplains
Center for Practical Bioethics
The Gerontological Society of America
Hospice and Palliative Nurses Association
National Association of Catholic Chaplains
National Association of Directors of Nursing Administration in Long-Term Care
National Association of Jewish Chaplains
National Association of Neonatal Nurses
National Association of Social Workers
Social Work Hospice and Palliative Network
The full text of the new Guidelines is available here.
Q: What are the implications of palliative care for public health care policy?
A: Palliative care can significantly improve patient satisfaction and save an
estimated $6 billion a year by avoiding expensive treatments that patients and
families do not want.
(Source: R. Sean Morrison, MD, President. American Academy of Hospice and Palliative
Q: What is an Advance Directive?
It is a living will that allows you to document your wishes concerning medical treatments at the end of life. We encourage you to read from from the New York Times "Making Your Wishes Known at the End of Life" by Pauiline W. Chen, M.D.
Nathan Kottkamp, Chair of National Healthcare Decisions Day, writes:
Advance directive documents are only a piece of the puzzle. It is the conversation and the thought that goes into these documents that is absolutely crucial. Furthermore, advance planning is a process, it should be revisited often.
National Healthcare Decisions Day (www.nationalhealthcaredecisionsday.org), exists to encourage the public to take action with respect to their own advance healthcare planning and to ensure that providers are doing a better job of incorporating stated wishes into the delivery of care.
If you haven’t discussed and documented your wishes, do so now. If you have, take the opportunity to revisit your previous choices, be sure they remain current, and make sure your loved ones are aware of those wishes.
Find more information at the Advance Directives/Living Will links below.
Palliative Care Information Links:
getpalliativecare.org website – provides clear, comprehensive palliative care information for people coping with serious, complex illness.
Click here for their one page “What should you know about palliative care?”
Another excellent resource is "What You Need to Know About Palliative Care" from U.S. World & News Report.com (http://money.usnews.com/money/blogs/the-best-life/2013/01/23/what-you-need-to-know-about-palliative-care)
A member of HealthCare Chaplaincy posted this comment to the article:
- "This article does an excellent job of explaining and making the case for palliative care, which relieves suffering and matches informed treatment choices to the patient’s and family’s goals and values, as well as the importance of advance planning in “having the conversation” about one’s wishes. Palliative care is interdisciplinary team care including physicians, nurses, professionally trained health care chaplains, social workers, and others. Palliative care and care intended to cure go hand in hand.
"The article presents well that palliative care is care for the whole person. I wish to elaborate on that by saying that the whole person consists – in broad terms – of body, mind, and spirit. By spirit, I mean one’s personal source of inner strength, the spiritual core, that each of us draws upon to help us heal. Spirit may be grounded in religious beliefs, practice, or community or have nothing at all to do with religion. I hear every day from my colleagues at HealthCare Chaplaincy in New York who are board certified health care chaplains and who serve on palliative care teams in hospitals how palliative care can be the best resource and source of support for patients and loved ones.
"When one is diagnosed with any serious illness such as cancer, a referral to palliative care should take place. But unless that referral is an established protocol, it may not happen. If so, I urge patients and families to speak with the health care chaplain on the team, who can advocate for the referral to occur."
The Center to Advance Palliative Care (CAPC) provides health care professionals with the tools, training and technical assistance necessary to start and sustain successful palliative care programs in hospitals and other health care settings.
Interview with palliative care pioneer Dr. Diane Meier , Director of The Center to Advance Palliative Care, on how people struggle with serious, sometimes terminal, illness: Watch video. Read transcript.
Read Dr. Meier's excellent summary of palliative care impact on quality and cost- policy implications
MSNBC/Kaiser Health News series on the benefits of palliative care.
Transcript of national roundtable discussion of palliative care experts.
Findings about the role of spirituality and professional chaplains within palliative care by an All-Star panel of physicians, nurses, professional chaplains, social workers, professors, and university level researchers.
Amy Berman, a registered nurse and health foundation executive receives a diagnosis of terminal breast cancer and, with the help of a doctor who respects her goals, forgoes aggressive treatment in favor of palliative care. Read her story and read "Learning From Amy Berman: Barriers To Palliative Care And How We Might Overcome Them" by Dr. Diane Meier
Palliative care is good for patients, families, clinicians, hospitals, and society: Archives of Internal Medicine commentary
Excellent article on palliative care’s benefits, misconceptions & interdisciplinary team that includes physicians, nurses, professional chaplains, social workers, etc. -- "The Palliative Care Option"
Palliativedoctors.org website – from the American Academy of Hospice and Palliative Medicine
"Why You Should Demand Palliative Care" – an informative PowerPoint presentation
Palliative Care is Comfort Care -- from the National Cancer Institute
Spirituality resources for health care professionals from City of Hope Pain & Palliative Care Resource Center -- includes City of Hope publications and other resources relating to spirituality in health care including articles relating to cross-cultural topics. There is a listing of tools for assessing spirituality and spiritual concerns, links to organizational position statements relating to spirituality, and recommended publications.
Advance Directives/Living Will Information Links:
Caring Connections – for Advance Directives information including for every state
Caring Conversations: making your wishes known for end-of-life care
Five Wishes – talking about and planning for care at the end of life
“Study: Living Wills Often Prove Useful” from National Public Radio
National Healthcare Decisions Day – a national day to inform and act
“Legal Guide for the Seriously Ill – Seven Key Steps to Get Your Affairs in Order” published by the American Bar Association on Law and Aging for the National Hospice and Palliative Care Organization.
Two excellent professional blogs: Pallimed (“a hospice and palliative medicine blog”) and GeriPal (“a geriatrics and palliative care blog”)
For Baby Boomer parents and their children: a very practical checklist What Millennials Need to Ask Their Parents