When should someone be offered Palliative Care?

Knowing when someone should be offered Palliative Care

Palliative care can be incredibly beneficial for those living with a serious illness, and offering this type of care at the appropriate time is vital to ensure the best outcome. Several studies have found the many benefits of palliative care, including its survival benefit in patients with certain conditions. 

Here, we are exploring who could best utilise palliative care, who delivers it, what symptoms it can help to manage, common conditions that could benefit from palliative care, when it may be offered by a doctor, and more. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of domiciliary care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global home care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about palliative care, we can help. 

Who is palliative care for?

Palliative care is designed for two types of people; those living with a serious illness who are experiencing excessive pain and/or symptoms due to their condition or the treatments being pursued, and those with a life-limiting condition that require end-of-life care to manage their pain and discomfort in the final months, weeks or days of their life. 

Palliative care may be offered to anyone this applies to, regardless of their age or health condition, and it may be given alongside other types of care or treatments. Every year, around 56.8 million people (including 25.7 million in the last year of their life) require palliative care.

This type of care is primarily for the person experiencing the condition, but it can help their loved ones, too. For those with a terminal diagnosis, palliative care can also help family, friends and other people involved in a person’s care to guide them through this difficult time with both practical and emotional support. 

What are some common conditions that might benefit from palliative care?

Palliative care may be offered to those with a serious illness, whether or not their condition is terminal. A few of the conditions that commonly receive palliative care include: 

• Cancer (34% of people receiving palliative care are thought to have this) 
• Heart disease and cardiovascular diseases (38.5% of people receiving palliative care are thought to have these)
• Chronic respiratory diseases, such as cystic fibrosis (10.3% of people receiving palliative care are thought to have these) 
• Dementia (for those looking to learn more about this, you may find our guide useful: The Benefits Of Palliative Care For Dementia)

Other conditions that may require palliative care include kidney failure, chronic liver disease, chronic obstructive pulmonary disease (COPD), multiple sclerosis (MS), Parkinson’s disease, rheumatoid arthritis, neurological diseases, AIDS, diabetes, congenital anomalies, drug-resistant tuberculosis, and more. 

What symptoms can palliative care help manage?

Palliative care has been found to be successful in helping to manage a number of distressing symptoms experienced by people with serious illnesses. Some of the symptoms it can help to manage include: 

Pain

For many of the aforementioned conditions, pain can be a symptom, and in some cases, this can be all-encompassing and life-altering. More than 30% of patients with cancer are thought to receive inadequate pain relief medication, so whether they experience acute pain, chronic pain, or something else, having this type of discomfort can be extremely difficult while battling a serious illness. 

Palliative care can help to manage this with medications such as carefully controlled opioid drugs, steroids, antidepressants, anticonvulsants, local anaesthetics, muscle relaxants and more, depending on the condition being treated. 

Shortness of breath

Difficulty breathing can be a common symptom for people with several conditions, such as advanced cancer, heart failure and more. Studies have found that breathlessness can become increasingly prevalent as a patient’s condition progresses, and this symptom can be extremely worrying and uncomfortable for the person experiencing it, as well as their loved ones and care team. 

Managing this symptom can benefit everyone involved in the process and help ease the discomfort of the patient.

Fatigue

Fatigue is commonly experienced in a number of conditions, but it is often found in those facing a serious illness. This could be as a result of the illness itself, or the treatment that is helping to improve the patient’s health. It can be caused by things like pain, eating issues, anaemia, and more. In any case, managing symptoms of fatigue can help to improve the person’s quality of life and give them the physical and mental energy to continue treatments. 

In some cases fatigue can be severe, and can therefore negatively impact the patient and their loved ones. It is thought to affect around 75% of patients with advanced cancer, so managing fatigue symptoms can vastly improve their quality of life.

Nausea

Nausea and vomiting are prevalent in patients living with a serious or terminal illness. This symptom is thought to be experienced by as many as 68% of patients with cancer, and in terminal patients in the last 6 weeks of life, nausea and vomiting is thought to affect more than 40% of patients. 

Feeling the constant need to vomit can be very upsetting and distracting, but palliative care can help find ways to manage this symptom, and as a result, greatly improve the person’s quality of life. 

Depression

For those tackling a serious condition or who have been diagnosed with a terminal illness, depression can be a common and understandable symptom as they come to terms with the reality of their situation, and continue to experience frustrating symptoms on a daily basis. 

Palliative care can help to manage the symptoms of depression, and studies have found early palliative care for those diagnosed with advanced cancer led to a lower risk of depression. 

When will palliative care be recommended? 

Palliative care will often be recommended by the GP in charge of the person’s care, or the doctor in charge if they are in hospital. This type of care can be useful at any point in an illness, but it has been found to be most beneficial when implemented as early as possible, for example, immediately after a person has been diagnosed. 

If you have been diagnosed with a terminal illness, palliative care will often be made available to you as soon as you receive a diagnosis so you can make the most of this type of care. However, it is important to remember that it can be offered alongside other therapies and types of treatment, so being offered palliative care does not mean all treatment options have been exhausted, and does not mean that end-of-life care has begun. 

You can learn more about this in our guides: The 5 Stages Of Palliative Care and End Of Life Care vs Palliative Care

The palliative care team managing your care should discuss what this all means before you begin, and speak with you about things like:

• The symptoms you are experiencing
• The current treatments you are undergoing
• How the illness is affecting your mental health and mindset
• How the illness may be impacting your family and loved ones 

Together, you and the palliative care team will build a plan that works for everyone, with the main goal of preventing your symptoms, easing any pain you are experiencing, and improving your day-to-day quality of life. This palliative care plan can be designed to work around any other treatments you are receiving. 

As well as your physical symptoms, your palliative care team will usually take the time to address any other concerns you have, answer your questions, and provide both practical and emotional support if needed. This period of time can bring with it some difficult decisions and frustrating emotions, so palliative care is designed to be a more holistic approach to treatment that encompasses a lot of the emotional or spiritual questions, financial concerns, and practical elements that are typically left out of other types of medical treatment. 

In most cases, the earlier you can begin palliative care, the better. This is because many studies have discovered the benefits of implementing palliative care early in order to complement other treatments, and improve quality of life. For example: 

• A 2015 study found patients with serious illnesses who received palliative care ended up living longer than those with similar conditions who did not receive this care.
• A 2020 study on the impact of early palliative care found it to be a valuable, cost-effective component in the care of patients with cancer to improve quality of life.
• A 2023 study supported previous findings that early palliative care interventions have been proven to be effective in improving quality of life in patients with cancer, particularly in those with advanced cancer.

Ultimately, it is important to put aside any misconceptions about palliative care and its connotations with end-of-life in order to implement this type of care early and experience the many benefits. If you or your loved one are receiving palliative care at home, or have been recommended this, our award-winning home care at Home Instead could help by offering you bespoke, person-centred care that can complement the palliative care process offered to you by medical professionals. If this is something you would like to discuss, you can reach out to our team to speak about what you need most at this time. 

Home Instead is an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.