What is Palliative Care?
Palliative care is a philosophy of care that focuses on symptom management, goals of care, advanced care planning, and quality of life issues at any point in a disease process. Hospice shares a similar philosophy, but assumes that a person is no longer pursuing life prolonging treatments and is in their last 6 months or so of life.
What is Palliative Care Consult?
A palliative care consult is an opportunity for patients, families, clinicians, and care providers to express concerns or worries about a patient. These may include addressing relentless symptoms, assessing patient/family goals, clarifying prognosis and treatment options, POLST issues and/or placement issues.
Primary goals:
To clarify and solidify a care plan that is realistic and consistent with the patient’s needs
Assist with symptom management
Ensure patients understand their medical condition and prognosis (if they desire such information)
Collaborate with social workers and/or Chaplains regarding patient/family anxiety and suffering
Improve communication between patients, families, and multidisciplinary team
Discuss options for advanced care planning
After the consult, recommendations are made to the referring provider and appropriate team members.
A consult is ordered by the patient’s PCP, but anyone involved with a patient’s care may initiate a referral.
A consult may be done by a Nurse Practitioner, Social worker or both, depending on the situation.
What type of patients are appropriate for referral?
Patient has a complex medical illness with little or no advanced care planning
Significant family distress and dynamics
Patient has multiple physicians with conflicting agendas and prognostication
Chronic and/or progressive illness with frequent ER utilization or hospitalization
Progressive or poorly controlled symptoms (i.e. Pain, dyspnea, nausea, fatigue, depression, anxiety, Chronic weight loss, spiritual distress)
Declining functional status
Confusion and/or discordance regarding the care plan