When they hear "palliative care," most people think "hospice"--but this isn't quite correct. While hospice does include palliative care, palliative care is not limited to patients qualified for hospice. Palliative care focuses on relief from the symptoms of illness and addresses physical, emotional, and spiritual needs. Many hospital systems now employ palliative care specialists and some outpatient centers do as well. Some hospice organizations are offering palliative care services in the home to patients not qualified for hospice.
There are a number of situations in which a palliative care consultation could be helpful. For example, if you've just been diagnosed with a serious cancer and are unsure whether or not to pursue treatment. Palliative care teams are expert at helping to clarify your goals and determining how different treatments--or no treatment at all--mesh with these goals. Or, if you have cancer and receiving treatment but suffering symptoms that you need help to alleviate, such as pain or nausea or loss of appetite. Or if you have a different serious illness--ALS or Parkinson's or Chronic Obstructive Lung Disease (COPD) or heart failure--and want assistance managing symptoms such as anxiety or depression or fatigue or constipation or shortness of breath or pain.
In the hospital, you'll often meet with a team of palliative care specialists including a palliative care physician, nurse, social worker, therapist, and chaplain. In the clinic, you may meet with the physician first and later other members of the team depending on your needs. Care is comprehensive and addresses all areas of suffering.
Palliative care teams are trained to really listen--and to help you identify your goals. Palliative care consultations will include discussions about end-of-life wishes, and will ensure that you've completed an advanced directive. The focus is on quality of life, and a palliative care team should try to get to know what you value. Many other physicians have very limited time to spend with you, the average clinic appointment lasting only 7 minutes; palliative care teams have much more time.
If you'd like to learn more about palliative care, I recommend reviewing the web site, Get Palliative Care. Dr. Steve Pantilat is a palliative care physician at UCSF and he exhaustively reviews palliative care on Youtube here. If you have questions, or would like assistance in seeing a palliative care physician, please feel free to contact me.