Most people associate medical care with cures and recovery. That's why it's often very difficult for family members to understand and accept the notion of palliative care – comfort care given to a patient that's not intended to cure, but instead to ease the pain associated with terminal or chronic illness. When a patient decides in favor of palliative care, it's often their family members and loved ones who have the most difficulty handling all of the possible implications of that choice. However, there are a lot of fundamental misunderstandings associated with the use of palliative care. Take a look at some of the most common misconceptions and learn what you need to know when a loved one chooses palliative care.
Misconception: Palliative Care Means Giving Up
Because most hospice centers provide palliative care, many people associate it with end of life care, and it's true that palliative care is a very important part of hospice and end of life care. However, palliative care can also be given in conjunction with curative treatments. The point of palliative care is to ease pain and improve quality of life, no matter where the patient is in the treatment process.
However, even when palliative care is chosen as an alternative to curative treatments as opposed to a complement to curative treatment, it still doesn't mean that the patient has given up. It means that they have chosen to spend the rest of the time they have as comfortably as possible, instead of fighting something they've accepted as inevitable. Often, that's the healthiest decision available to a terminal patient, though that may be hard for the patient's family and loved ones to accept. Your loved one's doctor or hospice care provider may be able to recommend counseling service for you or any other family member who is having difficulty coming to terms with a patient's choice to accept only palliative care.
Misconception: Palliative Care is Unnecessary Because Treatment Already Includes Pain Management
It's easy to understand why you might think that palliative care is unnecessary. It seems logical that if your loved one is being treated for a condition, that pain management for that condition would be part of the treatment. However, that's not always the case. Many patients, particularly elderly patients, are undertreated for pain. Studies show that between 25% and 50% of community-dwelling elderly patients and 45% to 80% of nursing home-dwelling elderly patients are suffering from important pain problems.
Why is pain so undertreated? There are a variety of reasons. Patients may underreport their pain for fear of not being taken seriously or for being seen as drug-seeking. Sometimes doctors or family members discourage pain medications for fear of dependency. Elderly people with dementia, or any person whose condition presents with mental confusion, may not be able to ask for pain medication when needed, and doctors and caregivers may miss or mistake signs of pain.
For all of these reasons, palliative care can be an important contribution to a patient's medical treatment. Palliative care teams are well-versed in determining whether pain exists, even when the symptoms are atypical or the patient has difficulty asking, and they're also skilled in managing pain in a way that is safe and effective for the patient.
Misconception: Palliative Care Speeds up Death
Whether it's used in place of curative treatment or in conjunction with curative treatment, there's a widespread belief that palliative care hastens the end of life. If you believe this, you aren't alone – even many doctors make this mistake.
If anything, the truth seems to be the opposite. According to a study described in the New England Journal of Medicine, patients receiving palliative care not only suffered less pain and experienced less depression, they also received a survival benefit of more than two months. The palliative care actually seemed to extend their lives. It may be that pain and decreased quality of life actually shortens patient lifespans, and addressing these issues allows the patient more time than they would have otherwise.
If you have a loved one that is suffering from a chronic or terminal illness, palliative care is an option that they should definitely explore. You can help by supporting their choices and helping to explain the benefits of palliative care to other concerned parties.