Summer 2023 Newsletter
Addie Fleming, MNSc, RN, CCRN, CNE, ACUE – Assistant Professor
Sarah Dearing, MSN, RN – Chair, AASN Programs
Arkansas State University, School of Nursing
The worldwide population is getting older due to advances in medical care. However, the needs of the aging population differ greatly from the needs of the younger population. Compared to younger adults, older adults often live with multiple complex medical diagnoses, functional dependency, cognitive decline, and increased frailty. As a result of the differences, the needs of the older adults, caregivers, and their families are often unmet due to the complexity associated with older adults’ medical care. Palliative care can be used to provide the needed support in all aspects of the older adults’ medical care (Schelin, et al., 2023).
Palliative care is derived from the word “palliate”, which means to comfort. More specifically, palliative care is a clinical approach of providing comfort to a person by identifying and addressing the physical, psychological, social, and existential suffering of the person related to an illness, injury, or disease process (Tolchin et al., 2022). Palliative care focuses on providing the best quality of life for a person through treatment and management of the symptoms they experience. All persons receiving palliative care experience an increase in communication from the physician and care team specific to care, decrease in health-care utilization (including hospital stays), and improved satisfaction with their quality of life (Schelin, et al., 2023). Palliative care can be basic (primary) or complex (specialty) depending on the needs of the older adult. Basic palliative care can be provided by any clinician and is typically used for a general approach. However, for those requiring a more specific treatment plan can receive care from a specialist trained in hospice and palliative medicine (Tolchin et al., 2022). An older adult or caregiver can find a palliative care provider by visiting the National Hospice and Palliative Care Organization (2023) at https://www.nhpco.org/find-a-care-provider/.
Palliative care is often mistaken for hospice care because both healthcare services focus on patient needs and quality of life, however, the two services are not interchangeable. Both services focus on the person’s needs and quality of life, but hospice care focuses on the period closest to death. Hospice care is specifically reserved for persons at the end of life who are expected to have less than six months to live and allows for limited treatments. Palliative care focuses on managing the person’s treatments and other needs to maintain the highest quality of life for the person with the illness, injury, or disease (CaringInfo, 2023).
The World Health Organization (2020) estimates that globally about 14% of patients who need palliative care are receiving it – meaning an estimated 56.8 million people are in need of palliative care. Older adults and their caregivers often are not aware of the services and benefits associated with palliative care. The following bullet points summarize some services and benefits of this ‘extra layer of support’ as highlighted by CaringInfo, a program of the National Hospice and Palliative Care Organization (2023):
- Focuses on managing symptoms of the illness, injury, or disease to provide the highest quality of life possible (pain control, stress reduction, etc.)
- Curative and therapeutic treatments can continue (dialysis, chemotherapy, surgery, etc.)
- Available to persons in any care setting (home, nursing home, hospital, etc.) usually by a team of specially trained doctors, nurses, and other specialists
- Medicare, Medicaid, and many insurance plans often cover the medical portions, including the Veterans Affairs (VA) for veterans.
- Non-medical services include help with insurance forms, help with options for care and housing, help with advance directives, and spiritual care.
- All services (medical and non-medical) provided for as long as they are needed and can change based on the person’s need.
As you can see, palliative care is a resource for anyone living with an illness, injury, or disease that causes distressing symptoms. Older adults and caregivers benefit from palliative care through improved management and treatment of the symptoms they experience. A higher quality of life is often the result of palliative care for both the caregiver and the older adult (World Health Organization, 2020) – so everyone can focus on enjoying their lives and not managing an illness, injury, or disease.
CaringInfo. (2023). What is palliative care? https://www.caringinfo.org/types-of-care/palliative-care/
National Hospice and Palliative Care Organization. (2023). Find a care provider. https://www.nhpco.org/find-a-care-provider/
Schelin, M. E., Fürst, G. C., Rasmussen, B. H., & Hedman, C. (2023). Increased patient satisfaction by integration of palliative care into geriatrics: A prospective cohort study. PLOS ONE, 18(6), 1-15. https://doi.org/10.1371/journal.pone.0287550
Tolchin, D. W., Brooks, F. A., & Knowlton, T. (2022). The state of palliative care education in United States physical medicine and rehabilitation residency programs: Heterogeneity and opportunity for growth. American Journal of Physical Medicine & Rehabilitation, 101(12), 1156-1162. https://doi.org/10.1097/PHM.0000000000002072
World Health Organization. (2020, August 5). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care