The Role of Palliative Care in Cancer Patients

Palliative Care and Its Focus

Palliative care is intended to reduce problems or symptoms linked to diseases such as cancer. The treatment of cancer is meant to control or cure the disease. Palliative care concentrates on the quality of life and comfort at any level of the disease. In some cases, health experts may recommend palliative care for persons at the end of life (El-Jawahri et al., 2016). Therefore, it incorporates care for persons at all levels of life-changing illnesses. It is also referred to as supportive care or comfort-oriented care. Empirical evidence has pointed to the fact that palliative care has a wide range of advantages in promoting the well-being of a patient. For instance, it can be advantageous when receiving or seeking cancer treatment, when a patient is engaging in clinical trials to assess the quality of life or treatments issues, or when a person has an advanced stage of disease such as cancer and may be nearing the end of life (Friedrichsdorf et al., 2015).

The Purpose of Palliative Care

According to Sewtz et al., (2018) the primary purpose of palliative care is to remove, reduce, treat and prevent discomfort. It attempts to facilitate quality of life and personal satisfaction of the patient. Additionally, palliative care incorporates services offered by a wide range of health experts for practical, spiritual, emotional, and physical concerns. Such services may be delivered in and sustained in different settings at various times (Sewtz et al., 2018). The practice is referred to as continuity of care. In this regard, palliative care can be delivered in physician offices, outpatient clinics, inpatient hospitals, assisted living facilities and health care offered at home. For instance, for spiritual, social, and emotional well-being, psychiatric or psychiatrist nurse prescribes and evaluates medication for emotional challenges and provide counseling services. Similarly, social worker or counselor may provide assistance regarding thoughts and emotions and assist in searching for mechanisms to manage concerns while bereavement and grief counselor helps in dealing with challenging times especially after death or any loss or expected loss especially physical abilities loss (Friedrichsdorf et al., 2015). On the other hand, physical wellbeing specialists such as nurse practitioner, medicine specialist, oncologist, and primary care physician help in offering palliative care by supervising health care, prescribing medication, and planning treatment plans. Again, the pain specialists function with the oncologists or primary care doctors to monitor and prescribe pain medications to the patients (El-Jawahri et al., 2016). Finally, attorneys are involved in palliative care through the creation of wills and advance directives.

The Quality of Life in Palliative Care

The quality of life for palliative care should be provided to patients who desire to and carry on treatment and life-prolonging therapies. The practitioners in palliative care collaborate with other professionals to take responsibility for persons with advanced or severe illnesses (McCaffrey, Bradley, Ratcliffe & Currow, 2016). Importantly, palliative care services are offered in the setting of the hospital and concentrate on symptom management by the expert and matching management to achievable and informed family and patient goals (Sewtz et al., 2018). Moreover, the teams offering palliative care also provide pragmatic support and community resources mobilization to guarantee safe and sustainable living settings after the patient is released from the hospital and ensure continuity of support across a different care environment such as hospice, nursing home, home, and hospital (Friedrichsdorf et al., 2015).

Benefits of Palliative Care in Cancer Patients

A study by El-Jawahri et al., (2016) highlighted that palliative care enhances family and patient well-being, quality of life, symptom distress, and improves survival in cancer patients. Furthermore, it also minimizes unnecessary utilization of hospitals, treatment and diagnostic interventions, and non-important intensive care. The negative effects of compliance on the conventional structure of comfort and curative care are substantial. Patients suffering from cancer and their kin normally report misunderstanding of the kind of their treatment, insufficient time with their physicians, pain, and problems of treatment (El-Jawahri et al., 2016). Additionally, dominant feats of unrestrained physical symptoms such as breathlessness and pain are usually vindicated. A study by Gaertner et al., (2017) demonstrated that 33 percent of cancer survivors suffer from anxiety. A third of survivors registering pain described it as severe or moderate. Again, pain is linked to various negative outcomes such as depression, functional decline, delirium, and other mood disorders as well as the progression of chronic pain syndromes. On the other hand, non-pain symptoms such as breathlessness, psychological symptoms (delirium), anxiety, and depression are also prevalent in undertreated or under-assessed cancer patients (Gaertner et al., 2017).

Palliative Care and Stress Reduction

Palliative care is essential in reducing the damaging effects of pain and other signs of distress in patients. According to Friedrichsdorf et al., (2015), protracted stressors linked to severe disease reduce immune reserve in the patient. Therefore, interventions in palliative care tend to provide a quality of life process which interferes with this pathway and facilitates enhanced outcomes. An association between physical and psychological stressors and reduced host resistance may also describe findings of raised death in stressed caregivers of cancer patients (Friedrichsdorf et al., 2015). Such family caregivers are five times at risk of experiencing post-traumatic stress and extended grief disorders.

Personalized Palliative Care for Quality of Life

Attaining quality of life for palliative care demands competency for oncology specialists and redesigning of the system that routinizes delivery of primary and expert-level palliative care in conventional cancer care. Sewtz et al., (2018) suggested that the primary purpose of palliative care is to enhance the quality of life of the patient. In this regard, the process should concentrate on comprehending what is essential to the patient and the best ways to satisfy the patient’s spiritual, cultural, emotional, social, and physical needs (Sewtz et al., 2018).

Palliative Care Interventions for Quality of Life

Symptoms of physical concerns include pain, vomiting or nausea, energy loss, weakness, fatigue, insomnia, sexual dysfunction, infertility, cognitive issues, skin changes, infection, appetite loss, lymphedema, and recurring chronic pain. Consequently, possible palliative care interventions include massage, occupational or physical therapy, medications to manage side effects, yoga, exercise, and/or nutritional counseling (Gaertner et al., 2017). To deal with emotional needs such as grief, stress, anger, anxiety, fear of the future, and beginning relationships, the nursing expert should introduce interventions such as counseling (faith-based, spiritual, and emotional), meditation, support groups, and medication. Thirdly, patients also experience practical or day-to-day needs such as work and transportation challenges as well as financial changes, insurance matters, children care, and will. Therefore, palliative care experts should introduce interventions such as legal advice, help with insurance matters, training, care planning, estate and wills planning, and tax advice (McCaffrey, Bradley, Ratcliffe & Currow, 2016).

The Role of Palliative Care in Reducing Suffering

Illness creates various uncertainties because of the financial burden, symptoms, and pain. The emotional challenge of extended hospital stays, confusing prescriptions, and several physician visits, and unpredictable life can be fearful and discouraging. For the actively dying and the chronically ill, palliative care offers an opportunity to reduce the suffering of the patient and families (El-Jawahri et al., 2016). In fact, it is team-based care and highly coordinated taking place several months before a patient starts hospice care. Conversely, hospice concentrates on forthcoming death and focuses on comfort instead of sustained treatment of primary disease. The previous palliative period concentrates on specialized care intended to enhance the quality of life for the family and the patient (Sewtz et al., 2018).

Palliative Care and Comfort

Innovation in medical care can permit patients to stay in the security and comfort of their families, especially at the period of unsure healthcare treatment and diagnosis. By concentrating on offering patients a reprieve from mental turmoil, physical stress, pain, and symptoms of severe disease, successful palliative care significantly improves the experience of end-of-life in different ways (Friedrichsdorf et al., 2015).

Trustful Connection in Palliative Care

Quality of life is achieved through palliative care because it establishes an opportunity for comfort, connection, and care options. In this regard, it creates a cohesive crew involving nurses, physicians, and other professionals who are committed to comforting their patients while offering informative care alternatives. Additionally, deeper links are created with this form of care, enabling precise and compassionate communication between the patients, healthcare provider, and families (Gaertner et al., 2017). In so doing, it helps to eliminate the fear of an unknown future since formulating a trustful connection is essential to the patient’s well-being. The experts of palliative care can offer a helping hand to the patient hence they explicitly explain treatment alternatives available. The aim is to form a reliable support system that guarantees patients acquire the care they require, both where and when they desire it. Palliative care offers a chance to make patients as contented as possible (El-Jawahri et al., 2016).

Personalized Care in Palliative Care

Palliative care facilitates the individualization of the quality of life. Since each person has exclusive spiritual, relationship, and circumstances convictions that affect the decisions, it is essential to offer personalized care. Palliative care evaluates the desires and symptoms of every patient and designs unique goals and plans. Such kind of care is an irreplaceable gift to the family who can later implement their hopes instead of creating impractical choices in a disaster (Sewtz et al., 2018). Most patients desire to spend their time in the comfort of their home deprived of pain. They also want to be comfortable with their friends and family and not be connected to a myriad of machines in the healthcare settings. Therefore, palliative care attempts to ensure that patients acquire the healthcare that they aspire when approaching their end of life (Friedrichsdorf et al., 2015). McCaffrey, Bradley, Ratcliffe & Currow, (2016) noted that the main purpose of palliative care is to make sure that the terminally ill persons are cared for and comfortable by reducing the burdens and stress linked with sickness and disease. For this reason, healthcare is customized to physical, spiritual, mental, and emotional care to advance the quality of life while saving money and time (McCaffrey, Bradley, Ratcliffe & Currow, 2016).

Financial Benefits of Palliative Care

Severe illness can cause a significant effect on the financial capacity of the patient. It can usually be a substantial setback to families, instituting extra stress. An extended stay in the hospital is expensive, irrespective of whether the patient has insurance coverage or not. Receiving a palliative care plan can assist in reducing much of the financial challenges placed on families and individuals, especially in the course of life-threatening illnesses such as heart failure and cancer (Gaertner et al., 2017). More importantly, palliative care is unified coordination of healthcare for the patient with chronic illness. Outcomes attained can be expensive saving because of innovation in the market and execution of value-based mechanisms and a departure away from the chaotic and fragmented fee-for-service medical models (McCaffrey, Bradley, Ratcliffe & Currow, 2016).

Palliative Care and Informed Choices

Disease and its treatment alter the quality of life of the patient. Therefore, a patient must have the capacity to develop informed choices on the aim of the medical interventions or treatment he/she should receive (El-Jawahri et al., 2016). Comprehending the intricacies of the disease and its management process is important. Moreover, conversations on end-of-life are difficult. In such circumstances, palliative care services can help with the discussion and educate the families and patients by delivering information and messages required in preparation for the future. Circumstances related to personal health require change, hence having a person to talk to at any time helps in reducing stress and anxiety (Sewtz et al., 2018).

Conclusion

The core purpose of palliative care is to enhance the quality of life of the patients. It focuses on comprehending the needs of the patients, including spiritual, cultural, emotional, social, and physical needs. Besides, it concentrates on removing, reducing, treating, or preventing discomfort (Friedrichsdorf et al., 2015). It attempts to provide an individualized satisfaction to the patient. A nurse practitioner can participate in palliative care by delivering direct care, care coordination with other team members, and explaining issues about treatment (Sewtz et al., 2018). Others may help in the supervision of health care, making referrals to professionals, and formulating treatment plans. It also involves various specialists such as a primary care doctor, social worker, pain specialists, nutritionists, spiritual leaders, and oncologists. Some of the interventions that can facilitate quality of life for palliative care include nutritional counseling, yoga, massage, occupational therapy, meditation, support groups, and counseling (El-Jawahri et al., 2016). More importantly, palliative care is critical to the quality of life because it provides care options, comfort, and connection to the patient. The deeper interaction between the healthcare team, patient, and families lead to clear communication and compassionate life. It also offers a trustful link which is essential to the well-being of the patient.

References

El-Jawahri, A., LeBlanc, T., VanDusen, H., Traeger, L., Greer, J. A., Pirl, W. F., ... & McAfee, S. (2016). Effect of inpatient palliative care on quality of life 2 weeks after hematopoietic stem cell transplantation: a randomized clinical trial. Jama, 316(20), 2094-2103.

Friedrichsdorf, S. J., Postier, A., Dreyfus, J., Osenga, K., Sencer, S., & Wolfe, J. (2015). Improved quality of life at end of life related to home-based palliative care in children with cancer. Journal of palliative medicine, 18(2), 143-150.

Gaertner, J., Siemens, W., Meerpohl, J. J., Antes, G., Meffert, C., Xander, C., ... & Becker, G. (2017). Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and meta-analysis. bmj, 357, j2925.

McCaffrey, N., Bradley, S., Ratcliffe, J., & Currow, D. C. (2016). What aspects of quality of life are important from palliative care patients’ perspectives? A systematic review of qualitative research. Journal of pain and symptom management, 52(2), 318-328.

Sewtz, C., Muscheites, W., Kriesen, U., Grosse-Thie, C., Kragl, B., Panse, J., ... & Junghanss, C. (2018). Questionnaires measuring quality of life and satisfaction of patients and their relatives in a palliative care setting—German translation of FAMCARE-2 and the palliative care subscale of FACIT-Pal. Annals of palliative medicine.