When treating patients with serious, chronic conditions, nurses often have to talk about uncomfortable subjects such as intensive treatments, prolonged care options, harmful side effects and death. During the diagnosis phase, it's important to speak with patients about palliative care.
Unlike hospice, which only begins after treatment has stopped, palliative care can begin immediately after diagnosis. The concept of palliative care entered the public spotlight last year after the death of singer David Bowie. According to Billboard, Bowie's son, Duncan Jones, released a letter written by Dr. Mark Taubert, a British palliative care physician who discovered that the singer's passing helped other patients speak about their conditions.
"At the beginning of that week I had a discussion with a hospital patient, facing the end of her life," wrote Taubert. "We discussed your death and your music, and it got us talking about numerous weighty subjects, that are not always straightforward to discuss with someone facing their own demise. In fact, your story became a way for us to communicate very openly about death, something many doctors and nurses struggle to introduce as a topic of conversation."
What is palliative care?
According to the U.S. Library of Medicine, the goal of palliative care is to help people with serious illnesses feel better. Unlike hospice, providers can administer palliative care at the same time as other treatments. The main goal is to provide comfort to patients who are experiencing pain and other negative side effects of the illness and medicine.
The New York Times reported on people who, though initially averse to palliative care, found relief and comfort after accepting the treatment. According to the source, many patients are hesitant to try palliative care because they mistake it as an end-of-the-road option. However, palliative care can offer patients prescriptions to help mitigate the side effects of other treatments, assistance from social workers and access to knowledgeable help at any hour, day or night.
Talking to patients about palliative care
When talking to patients about their options during treatment, nurses may experience resistance from patients who think of palliative care as a final option. It's important to remind them that it is not the same thing as hospice and that it will in fact make them feel much better while they are receiving other treatments.
Keep the focus of the conversation on providing comfort and avoid talking about post-treatment scenarios. Caring Info explained that sometimes it's best to ask questions and mindfully listen to the answers before proceeding with your explanation of palliative care. Ask the patient about their fears, in regards to the treatment. Ask what his or her thoughts are about quality of life. Once you've heard the answers to your questions, you'll be able to better structure your conversation about next steps and how palliative care can help.