Last week I wrote about Hospice care. Today I am going to focus on Palliative Care. 


WHAT is Palliative Care?
Palliative Care is an additional layer of support for individuals facing a serious or chronic illness, such as cancer, Chronic Obstructive Pulmonary Disease (COPD), kidney failure, Alzheimer's, Parkinson's, and many more.  Individuals seeking Palliative Care might still be seeking aggressive treatment for the illness.  Palliative Care can also be started earlier, and then proceed into Hospice as the illness progresses.

WHO provides care?
Similar to Hospice, Palliative Care is a team-based approach. Members of the team can include:

• The patient's personal physician
• Palliative Care physician
• Palliative Care nurses
• Social worker
• Chaplain
• Pharmacists
• Nutritionists
• Massage therapists

WHO pays for Palliative Care?
Most insurance plans, including Medicaid and Medicare cover the costs of Palliative Care.

WHERE is Palliative Care provided?
Similar to Hospice, Palliative Care can be provided in a variety of settings - including the hospital, outpatient settings, at home, in a nursing home, or in a residential hospice.  Again, it is not a place where you go, just like Hospice, Palliative Care comes to you. 

ARE Hospice and Palliative Care the same thing?
While some of their components overlap, they are not the same thing.  Some of the similarities include: focus on quality of life, a team approach, an added layer of support, family and caregiver care, as well as pain and symptom management.  

HOW is Hospice different than Palliative Care?
Here are a couple of the main differences. 

Hospice

• 6 months or less left of life
• Care, not cure  

Palliative Care 

• Any stage in a serious illness
• Can be provided alongside curative treatment

Example:
Betty receives a diagnosis of advanced lung cancer.  The prognosis is not great, but they have some options for how to try to cure her.  Betty asks for Palliative Care services to help support her and her family, pain management as she goes through treatment, and the other supportive services that Palliative Care provides.  Betty is surrounded by not only her trusted physician, but other experts who are familiar with serious illnesses. They are going to try everything to cure the cancer as best they can.  While they do this, Betty's Palliative Care team is helping in many ways to improve or maintain her quality of life.

Fast forward 1 year.  Betty has gone through multiple treatments for her cancer, but it has still advanced.  At this point, her primary physician and Palliative Care physician agree, she has less than 6 months left of life.  They suggest that she move forward with Hospice care.  Betty then gets a new team of support, who are familiar with end of life care.  They are focused on making her as comfortable as possible.  They also are helping her family cope with the loss they are about to experience.  Betty is able to live at her daughter's house because she is familiar with her space and comfortable there.  Her Hospice care team takes great care of her, even when she is in her own bed.  Her family feels comforted as well, knowing that expert care is only a phone call away, 24/7.

Fast forward 4 months.  Betty has died.  She was surrounded by her children, and her Hospice care team arrive shortly after.  Her children are having a hard time dealing with the loss of their mother, so they seek bereavement counseling from the Hospice team for the next 13 months.

For more information on Palliative Care, go to the Get Palliative Care website, as well as this particular handout. 

In addition to National Family Caregivers Month, November is of special importance for individuals and families experiencing Alzheimer's Disease.

I've found that commonly, the term "Alzheimer's" is misunderstood. I've heard people breaking it down as "Alzheimer's -- Alt, like "Old" in German, as in, Old Timer's".. as if it was a normal part of aging. The thing is, it's not.

The name Alzheimer's originated in 1901, when German psychiatrist Alois Alzheimer identified the first case of what came to be known as Alzheimer's Disease.

The Alzheimer's Association website provides great information and resources. Below are the basics about Alzheimer's. Click here for the full website.

Alzheimer's is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

Alzheimer's and dementia basics

• Alzheimer's is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 80 percent of dementia cases.
  Learn more: What We Know Today and Understanding Dementia.

• Alzheimer's is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s.
  Learn more: Early Onset Alzheimer's and Risk Factors
• Alzheimer's worsens over time. Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer's is the sixth leading cause of death in the United States. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions.
  Learn more: 10 Warning Signs and Stages of Alzheimer's Disease.
• Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.  
  Learn more: Standard Treatments, Treatment Horizon, Prevention and Clinical Trials.

Caregiving can be many things. It can be rewarding, enlightening, and at many times very enjoyable. It can also be exhausting, mentally and physically.

November is National Family Caregivers Month. As you reflect on your role as a caregiver, now is a great time to think about ways you can take care of yourself. It is important to give care not only for your family member, but also for you. What are some ways that you can take care of yourself in this next month?

Maybe you could..

• Go to a movie           
  
• Take a bath
• Call a friend
• Go on a date
• Walk the dog
• Journal
• Listen to music
• Your idea here

The important thing is that you make time for yourself.
For me, I'm going to go have a cup of tea.

Here are some great resources for caregivers.
http://caregiveraction.org/
http://www.alz.org/care/honor-caregiver.asp