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Wednesday, August 13, 2014

What is palliative care?

The natural progression of chronic obstructive pulmonary disease (COPD) may ultimately lead to dyspnea, anxiety, depression, discomfort, and pain. When it becomes apparent any of these symptoms is chronic, it's time to make the shift to palliative care.

Shawna Strickland, in the April issue of AARC Times, "Palliative Care for the Patient with Chronic Pulmonary Disease," defines palliative care as follows:
Palliative care: the application of care strategies to alleviate the patient's suffering.  Many times, palliative care is confused with hospice care.  
Hospice care: is the shift in care goals from curative to comfort only.  Patients qualify for hospice care when their life expectancies fall to six months.
Curative care:  Efforts are made to cure symptoms and treat the disease.  This is generally done until  
Palliative care is often given in conjunction with curative care, and is generally started when the disease progresses to the point where symptoms such as pain, discomfort, anxiety, depression and dyspnea (air hunger) become chronic

It includes medicines like Ativan to reduce anxiety,  morphine to reduce the feeling of air hunger, or dyspnea, and morphine and other medicines to reduce pain and suffering.  Morphine or other opoids and cough suppressants may be needed to help reduce or prevent excessive coughing.  Oxygen may also be indicated to reduce the feeling of dyspnea.

In her article, Strickland said:  "Researchers have shown that respiratory therapists may have a poor understanding of palliative care principles and may not be prepared for these chronic disease and end-of-life issues.

Well, now you know.  What we do is a part of the palliative treatment.  Oxygen, and bronchodilator therapy may not always have a scientific benefit to the patient, although evidence suggests the placebo effect of albuterol may be all that is needed to sooth the mind of a patient.

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