While in their declining years, elderly people are naturally prone to chronic diseases capable of making their life difficult to live. Chronic illnesses often make their presence known through unbearable symptoms like pain or depression. This is where palliative care proves useful. Applying palliative care early on can help patients cope with symptoms, regain the quality of life and stable functioning. The approach covers a wide range of illnesses ranging from respiratory diseases to multiple sclerosis. Psychiatrists, massage therapists, and nutritionists are among a few specialist categories involved in treatment. Even chaplains can help patients, whenever necessary, addressing the problems of death and afterlife. Of course, the approach looks halted by the lack of programs, hospital revenue issues, and the abidance by recommendation not always followed by primary physicians or patients themselves. Overall, despite a number of disadvantages, palliative care is a desirable approach to medical treatment that deserves applying in geriatric medicine to help elderly people with chronic diseases.
Rather than be a solution to people on the point of dying, palliative care is a resource for whoever has a long-term illness with the potential of it leading to death (National Institute on Aging 23). Appropriate at any stage of a serious disease, palliative care is considered a part of hospice treatment. This type of treatment is applicable to emotional, physical, and psychological symptoms emerging in different phases of an illness. Put otherwise, palliative care helps with emotional traumas, physical pain, and treatment-related stress. The ones who qualify for palliative care are patients with incurable and progressive illnesses, inclusive of respiratory and cardiac diseases, Alzheimer’s, kidney failure, HIV/AIDS, multiple sclerosis, and amyotrophic lateral sclerosis – the list goes on and on (Senior Living n.pag.). It follows therefrom that the treatment covers a wide range of diseases being universal enough by nature. Hebert, Fowler, and Arnold (4) suggest that the most essential part of palliative care is that uncontrolled symptoms do not inflict pain on patients. Senior Living (n.pag.) believes the life exhausting symptoms of cancer minimized by palliative care. Thus, for example, the nausea, fatigue, and pain induced by cancer and medical treatment like chemotherapy can die down when influenced by palliative approaches. Relieved also may be symptoms, such as constipation, the shortness of breath, sleep issues, and the loss of appetite, to name only four.
While this type of care for the elderly with chronic illnesses does relieve them of symptoms and side effects, if fails to replace the primary care for a disease. Higginson, Finlay, Goodwin, Hood, Edwards, and Cook (n.pag.) state that clinical trials have established the link between palliative care and the successful evaluation and management of pain along with other symptoms (qtd. in Hebert, Fowler, and Arnold 4). According to Doyle, Hanks, and Cherny (n.pag.), the pain of the 85% to 95% of patients is relievable through oral regiments, which are not dose limited by disturbing side effects (qtd. in Hebert, Fowler, and Arnold 4). Valdimarsdottir, Helgason, Furst, Adolfsson, and Steineck (n.pag.) state that it is upon symptoms control ensured by palliative care that the wellbeing of the surviving family members depends (qtd. in Hebert, Fowler, and Arnold 4). Hallowell (16) states that the care leaves family and the patient satisfied with the facility and provider more than any other treatment does.
Scholars have found palliative care to be a difference-maker in terms of life quality if applied at the early stages of a disease (Lens n.pag.). Palliative care is also said to enhance decision-making and improve general functioning (American Dental Education Association n.pag.). The reduction of the levels of re-hospitalization, uncontrolled pain, and unaddressed depression and anxiety are all attributable to palliative care (Hallowell 16). As is evident from the range of specialists involved in palliative treatment, it can prove universal in the sense that different specialists can find a unique approach to any given patient. Senior Living (n.pag.) defines the palliative care team as composed of nurses, doctors, social workers, psychiatrists, pharmacists, massage therapists, nutritionists, counselors, and chaplains. Chaplains and ministers can address topics as regarding the afterlife, death, and religion or talk about feelings like remorse and disillusionment or frustration. Specialists may apply psychotherapy for conditions like depression and anxiety in the shape of relaxation techniques and the teaching of coping skills for handling negative thoughts, besides prescribing antianxiety drugs or antidepressants. Of course, if necessary, doctors can prescribe opiate like oxy- or hydrocodone or morphine to alleviate physical pain.
As beneficial as it is, the care has a number of disadvantages holding back its implementation. Christ and Sormanti (n.pag.), Norris, Strohmaier, Asp, and Byock (n.pag.), Sivesind, Parker, Cohen, Demoor, Bumbaugh, Throckmorton, Volker, and Baile (n.pag.), Sullivan, Lakoma, and Block (n.pag.) plenty of clinicians find it difficult for them to provide quality end-of-life care (qtd. in Hebert, Fowler, and Arnold 4). Healthcare providers have received little training in palliative care until recently. The majority of hospitals face the lack of palliative care programs or have difficulties elaborating new programs (Hebert, Fowler, and Arnold 4). Indeed, much remains undone since professionals require training in the assessment, control, and treatment of pain and upsetting symptoms (Davies and Higginson 18). Senior Living (n.pag.) notes that insurance companies like Medicaid and Medicare cover palliative care at least partially, yet not fully. Thus, for now, the lack of programs and staff qualification and the partial covering of care-related expenses seem to be quite serious disadvantages of the treatment.
In addition, Hebert, Fowler, and Arnold (10) state that hospital personnel may not be comfortable with this type of care any more than they may be aware of when it is that the staff should ask for palliative care consultation. The staff may feel uneasy about specific recommendations like the application of opioids for dyspnea. The discipline of a consultant may determine the willingness to accept a consultation and implement recommendations. Being consultants that they are, the palliative care team may not necessarily have primary physicians follow their recommendations. Under the program, the allocations may take a few months to produce due to dependence on clinical budget, whereupon it is supposed to support the time of palliative care clinicians. Outpatient palliative care clinic may be unavailable to hospitalized patients. Gravely ill individuals may be undesirous of completing the recommendations of both the primary physician and palliative care services or prove unable to, which particularly holds true for broken or debilitated patients over-reliant on family caregivers travelling from and to the clinic (Hebert, Fowler, and Arnold 11).
American Dental Education Association. “Palliative Care Physician.” ExploreHealthCareers.org. 2012. n.pag. Web. 1 July 2015.
Davies, Elizabeth, and Irene J. Higginson. The Solid Facts. Palliative Care. World Health Organization. 2004. 1-35. Web. 1 July 2015.
Hallowell, Nancy. “End-of-Life Palliative Care.” Today’s Geriatric Medicine. 7.5 (2015): 16. Web. 1 July 2015.
Hebert, Randy, Fowler, Nicole, and Robert Arnold. Palliative Care in Acute Care Hospitals. Pennsylvania: University of Pittsburgh School of Medicine. n.d. 1-18. Web. 1 July 2015.
Len. “The Unexpected Benefits of Palliative Care.” Web blog post. Dr. Len’s Cancer Blog. American Cancer Society. 20 August 2010. n.pag. Web. 1 July 2015.
National Institute on Aging. End of Life. Helping with Comfort and Care. NIA. January 2008. 1-72. Web. 1 July 2015.
Senior Living. “Palliative Senior Care.” 2 September 2011. n.pag. Web. 1 July 2015.