A relatively new discipline that has been steadily growing across the country has arrived at Tufts Medical Center. Unlike traditional medical care, which generally concentrates on finding a cure or giving treatment for a patient’s ailment, palliative care addresses the patient’s physical and mental pain and suffering, by focusing on symptom control and open, honest communication.
“The cornerstone of palliative care is determining the patient’s goals of care, rather than the medical team’s goals of care,” said neuro-oncologist and Director of Palliative Care Services Lynne Taylor, MD. “Medical professionals often assume the two are aligned, when in fact they are often very different. The palliative care team’s job is to focus on the patient’s symptoms and separate that from a focus on the patient’s outcome.”
Palliative care is usually offered to patients who have been diagnosed with a serious illness, and is provided by a multidisciplinary team of doctors, nurses, social workers, discharge planners, physical and respiratory therapists, all working closely together with the patient and family. Often mistaken for hospice care, which is offered to patients expected to live less than six months, palliative care is most effective when administered early in treatment, rather than just in the last few weeks of life.
“Today’s emphasis on diagnosis and treatment results in much less attention paid to prognosis, or the prospect of recovery. But many patients care about their prognosis the most,” Taylor said. “It can be quite difficult for medical professionals to discuss uncomfortable topics with patients and honestly tell them their prognosis. Palliative care promotes this understanding and fosters a smooth line of communication between the medical team and the patient and family.”
While Taylor admits that the quality-of-life benefits of palliative care cannot easily be measured, she notes that subjective measurements are not necessarily worse than quantitative measurements. As evidence, she points to a 2010 study, published in the New England Journal of Medicine, which found patients who received palliative care had a better quality of life and lived more than two-and-a-half months longer than those who were not provided it. “The research seems to indicate that patients do better, for longer, with symptom relief,” she said.
One of the main reasons Taylor decided to come to Tufts Medical Center from Virginia Mason Medical Center in Seattle was the opportunity to build a Palliative Care Service from the ground up. In Taylor’s vision for Tufts Medical Center, palliative care will be woven into every aspect of patient care, from inpatient to outpatient and from diagnosis to hospice.
In the short term, she hopes to see every seriously ill patient receive a palliative care consult and expects the palliative care team to know and understand the goals of care for each patient and family. Taylor also plans to introduce an educational component to the Palliative Care Service, promoting active participation by fellows and residents who have already developed interest in palliative care, often through their experiences in the surgical and medical ICUs.
Learn more about our palliative care service.