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Palliative Care: A Specialist’s Perspective

As a consulting physician in this field, I am often asked, “What is Palliative Care?” Palliative Care, or Palliative Medicine, has an official, fancy paragraph-long definition leaving you with a response of “Huh? What does that mean?” Because it is difficult to define, it may be easier to compare and contrast Palliative Care to what you may already know.

Palliative Care is, above all, not the same as hospice, or intended only for the end-of-life scenarios. Conversely, hospice is a type of palliative care, but only for a special population —those considered terminally ill having a life-expectancy of six months or less. Palliative Care, on the other hand, can be delivered as an extension of support at any time in the course of a  serious illness, and can be provided alongside other modalities of treatment, even curative or advanced treatments, in any setting, whether a hospital, nursing home, assisted-living, foster care or the patient’s home.

When the doctor or healthcare team says the all-too-familiar “there is nothing more that can be done,” be assured that is when Palliative Care shines as the team is ready to help the patient and family meet their goals and needs.

Palliative Care is not a pain clinic. A pain clinic deals only with pain and frequently utilizes procedures to effectively treat the pain. While Palliative Care is definitely focused on treating pain, it also addresses other significant symptoms (such as nausea, vomiting, constipation, and shortness of breath, to name a few), as well as non-symptom concerns of the patient, including the patient’s goals for care, and assuring advance directives are either introduced or completed with assistance.

Palliative Care is not about doing a procedure to a patient, but rather is better seen as an approach of care occurring together with the patient. I have discovered that, each person wants to know and understand, and to be known and understood; this requires getting to know the patient as a person. It has been said that the most important medical instrument in Palliative Care is a chair—used to sit down and get to know the patient individually to assist in planning his or her path. In other words, Palliative Care centers the patient in his or her healthcare journey.

Palliative Care and Hospice is a newly recognized specialty, with specialized training, education, and board certification required, like other medical specialties. Ideally, it is practiced as a team of health care professionals that includes a physician, nurse practitioner, social worker, nurse and sometimes a chaplain. At this time, Harbor Palliative Care is a consult service with the hopes of expanding to the full team approach in the future.

Palliative Medicine

Gerald A. Harriman, DO

Medical Director, Harbor Hospice
Palliative Care, Consulting Physician