Palliative care is a method of treating people with life-threatening illnesses that puts their quality of life first. Palliative care aims to keep patients free of pain and other uncomfortable symptoms like nausea and dyspnea. Additionally, it involves discussing the person's values and personal objectives with them and their family to help guide any additional treatments or interventions they could have (see "Advanced Care Planning").
Hospice is a care arrangement that includes palliative care for people who are expected to live for six months or fewer. However, palliative care itself can start as soon as a serious illness, particularly one that isn't likely to be treated, first manifests itself.
Planned care in advance
A document that would direct their medical care if they were unable to convey their preferences is absent from about two-thirds of American people. Filling out a health decision worksheet is a smart place to start because it will force you to think about and elaborate on your healthcare objectives. It asks you about the things in your life that are most important to you, your concerns over your prognosis, and specifics like whether you want to be put on a breathing machine or get tube-fed. You can use it as a benchmark for the following stage, which entails selecting a medical decision-maker (health care proxy) to represent your interests in the event of your incapacitation.
Visit /ADforms to download a free copy of a health decision worksheet and a health care proxy form. Advance Care Planning: A Handbook to Advance Directives, Living Wills, and Other Ways for Conveying Health Care Choices, published by Harvard Health Publishing, is available for purchase at /lw.
Review these documents every few years, or sooner if you receive a new diagnosis or experience other significant changes in your life, as your wishes and priorities will probably change as you age.
The course of heart disease
The effectiveness of modern medicine in treating cardiac illness has led to the progressive integration of palliative care in cardiology. With the heart and other organs becoming weaker and weaker, heart disease death is becoming less sudden and more of a steady decline.
People with heart failure may eventually struggle to breathe, and their bodies may bloat with extra fluid as a result of impaired kidney and heart function. Through nasal cannulas, which are tiny, flexible prongs that nestle just inside the nostrils, people can get oxygen. Small doses of morphine, which decreases pressure in the heart and lungs, are another option for palliative care. People's breathing becomes easier, and they experience less anxiety. Diuretics, which aid in the removal of fluid from the body, are frequently recommended in increasing doses.
Unpredictable direction
People can occasionally deteriorate quickly because heart failure has an uncertain course of progression. People with cancer who are no longer responding to treatment are aware that death is close at hand, as are their families. But even though heart failure is a serious, life-threatening disease like cancer, only around 39% of relatives of patients with heart failure anticipated a death, compared with 70% of families of patients with cancer.
Patients with heart failure who join hospice care following a hospitalization only live an average of 11 days. This implies that conversations about end-of-life care frequently take place during a crisis rather than earlier in the course of the illness, when patients could benefit from both focused, supportive treatment and advance care planning.
When a person is still functioning well, it is difficult to discuss end-of-life matters. In many areas, including our finances, employment, and interpersonal relationships, expect the best but prepare for the worst. That insight might serve as a wonderful starting point for a challenging but ultimately comforting conversation, whether you're making plans for yourself or a loved one.
