Making sense of medications near the end of life.

As in all things in life, the end of it should be tinged with a little common sense.

One of the silliest things I have do as a Palliative physician is to sift through the lists of medications that my patients are on and make the useless ones go away.

For instance, what sense does it make if you are suffering from cancer to take cholesterol lowering medications? Not only is it unnecessary, but they can interfere with chemotherapy and can certainly interfere with the enjoyment of life.

My advice to patients and their families who are in this situation, is to review the medication list with their physician and try to exclude anything that will not benefit them in the "here and now" and for comfort sake.

What good is the statistical chance of decreased stroke 25 years from now when the medications to do that make you miserable or worse, shorten your lifespan interfering with your chemo?

With medications such as the lipid lowering agents, daily aspirin therapy, and the like, once you achieve clinical remission or cure, then you can resume all those medications for long term preventative care.

What is Palliative Care?

Definition

Palliative care (pronounced pal-lee-uh-tiv) is the medical specialty focused on relief of the pain, stress and other debilitating symptoms of serious illness.

Palliative care is not dependent on prognosis and can be delivered at the same time as treatment that is meant to cure you. The goal is to relieve suffering and provide the best possible quality of life for patients and families.

Ensures quality of life

Palliative care is not a one-size-fits-all approach. Patients have a range of diseases and respond differently to treatment options. A key benefit of palliative care is that it customizes treatment to meet the individual needs of each patient.

Palliative care relieves symptoms such as pain, shortness of breath, fatigue, constipation, nausea, loss of appetite and difficulty sleeping. It helps patients gain the strength to carry on with daily life. It improves their ability to tolerate medical treatments. And it helps them better understand their choices for care. Overall, palliative care offers patients the best possible quality of life during their illness.

Palliative care benefits both patients and their families. Along with symptom management, communication and support for the family are the main goals. The team helps patients and families make medical decisions and choose treatments that are in line with their goals.

Different from hospice

Palliative care is NOT the same as hospice care. Palliative care may be provided at any time during a person`s illness, even from the time of diagnosis. And, it may be given at the same time as curative treatment.

Hospice care always provides palliative care. However, it is focused on terminally ill patients-people who no longer seek treatments to cure them and who are expected to live for about six months or less.

Provided by a team

Usually a team of experts, including palliative care doctors, nurses and social workers, provides this type of care. Chaplains, massage therapists, pharmacists, nutritionists and others might also be part of the team. Typically, you get non-hospice palliative care in the hospital through a palliative care program. Working in partnership with your primary doctor, the palliative care team provides:

• Expert treatment of pain and other symptoms
• Close, clear communication
• Help navigating the healthcare system
• Guidance with difficult and complex treatment choices
• Detailed practical information and assistance
• Emotional and spiritual support for you and your family

From Getpalliativecare.org