Growing Field of Medicine Coordinates Care for Chronically Ill

May 4, 2007 -- A little-known field of medicine has been steadily gaining the respect of medical professionals and patients over the last few years. A form of medical care that concentrates on reducing the severity of symptoms and improving the quality of life for the chronically ill, the practice of palliative medicine has been on the rise since 2000. According to the Center to Advance Palliative Care, approximately 30 percent of hospitals now offer palliative medicine, nearly double the number reported in 2000.

One of only a few types of medicine practiced as a team, palliative care brings together doctors, nurses, mental health professionals, and social workers to develop a coordinated care plan that helps patients and their families better deal with chronic illness. These teams perform a range of functions from closely monitoring a patient's care and intervening on his or her behalf to teaching family caregivers how to administer proper care at home to connecting families with counselors and psychologists following the death of a loved one.

Palliative care can benefit people throughout the course of illness, but the need almost always intensifies in the period before death. In earlier stages of illness, it may be needed to counteract the side effects of curative treatments, as well as early disease symptoms. Palliative care is the mainstay of hospice care, which serves patients once cure is no longer the goal, but when pain and other physical and psychological sympoms can become severe.

Several Institute of Medicine reports have examined the use of palliative care in the United States and other countries and suggest improvements that can be made. One report in particular, Improving Palliative Care for Cancer, reveals that improvements in the development and use of palliative care have not kept pace with medical advances that extend life and suggests the need for policy changes and more research. In addition, Cancer Control Opportunities in Low- and Middle-Income Countries identifies palliative care and pain control as services that can be provided even in very poor countries where other cancer services are minimal and resources are limited.

Describing Death in America: What We Need to Know explains that with better information, policymakers and the public are better equipped to hold providers accountable for quality of care given. Additionally, hospitals and institutions will be able to continually improve their approaches to patient care, project future needs for health care resources for the aging population, and advance research for end-of-life care. When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families recommends that all people involved in a child's treatment collaborate to promote effective symptom management, coordinated and continuous care, and the timely flow of information among caregivers, facilities, and families.

IOM's first report that addressed the importance of the emerging field of palliative care, Approaching Death: Improving Care at the End of Life, called for changes to improve end-of-life care, specifically through better training of health professionals, reformation of outdated laws, and the development of new payment options. In particular, palliative care should be recognized as a defined area of teaching, research, and patient care. The report continues to be an important resource on the subject.

• Improving Palliative Care for Cancer
• Cancer Control Opportunities in Low- and Middle-Income Countries
• Describing Death in America: What We Need to Know
• When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families
• Approaching Death: Improving Care at the End of Life

• The National Hospice and Palliative Care Organization
• Center to Advance Palliative Care