RESOURCES

Future of Palliative Care

Two very important things are needed for the expansion of palliative care: communication and education.

Communication

Communication is vital between medical and healthcare professionals, patients and caregivers.

The earlier palliative care is introduced into the course of an illness or treatment the better the understanding by the patient and caregiver of the scope of the illness and treatment, resulting in, a better outcome. The inclusion of a palliative care team (including social workers, psychologists, nutritionists, pharmacists, clinical massage therapists and acupuncturists, along with the pain management specialist and nurses) early in the treatment planning process can help alleviate the stress and anxiety of patients and their families, improving their quality of life.

Education

But communication cannot improve until the public and the medical community as a whole is better educated about palliative care. Palliative care has only been recognized as a sub-specialty of internal medicine since 2006. A 2009 study showed research programs, palliative care fellowships and mandatory rotations for oncology fellows were uncommon. According to Susan D. Block’s essay in Palliative Care and Ethics, edited by Timothy E. Quill and Franklin G. Miller, “we currently have only 11% to 15% of the hospice and palliative medicine physicians needed to provide full access to hospice and palliative medicine (HPM) services.” And “…there is no national plan to increase access, train more physicians or other healthcare professionals, or require palliative care competencies of other physicians to fill these gaps.”

Several medical schools are now offering HPM certification programs for practicing physicians and physicians who have completed residency. Advanced certifications are also available at some schools for nurses, nurse practitioners, pharmacists and social workers.

The need to have more palliative care specialists and increased understanding of palliative care in the rest of the medical community is crucial to expanding public awareness and access. Once awareness is raised, demand will grow.

Action

These actions would help to increase awareness and access of palliative care in the future.

  • Recognition that the aging population are living longer with cancer and other chronic illnesses and support programs are needed to help improve their quality of life.
  • Healthcare professionals should introduce palliative care at diagnosis, giving palliative care “a seat at the table” when designing a treatment plan for cancer patients. Caregivers should be brought into this planning process as early as possible.
  • Expand national policy discussions regarding professional, clinical, regulatory and financial issues to include caregivers and their critical impact on all of those issues, especially the financial impact.
  • Present to the public and promote palliative care as an option to relieve pain and suffering, supporting the patient and caregiver to achieve the best quality of life.
  • Medicare and Medicaid should adopt a palliative care benefit.
  • Make palliative care readily acceptable, available and affordable.