What do you understand about your diagnosis?
Who else should be in the room for this conversation?
What is most important to you right now?
These questions are among the first to be asked during palliative care consultations.
They represent core principles of palliative care: 1) patients should be informed and activated to participate in their care planning to the extent that they prefer; 2) care management occurs in partnership with family, friends, and the community; and 3) care plans should reflect patients’ goals and values. While these principles could and should be foundational to all healthcare, they are routine in palliative care.
Palliative care is specialized healthcare for individuals with serious, life-limiting illness. This whole-person approach addresses pain and symptom management as well as psychosocial and spiritual care for patients and their families. A multidisciplinary team consisting of nurses, physicians, chaplains, social workers, and other clinicians work collaboratively with patients’ usual clinicians as “an extra layer of support”, ensuring both continuity of care and specialized expertise.
Early use of palliative care works well for several reasons. Starting conversations early in the course of care and not during a health crisis allows for development of rapport among patients, families, and clinicians. Decision-making can occur over time, an important benefit when there are critical and often emotional decisions to be made, and for which preferences may change. Evidence is emerging that patients who receive palliative care early on may feel better physically and emotionally, may better be able to tolerate treatment, and some patients may consequently live longer than those who do not receive it.