Thursday, September 9, 2010

The Role of Palliative Care to Improve Quality of Life


Why do only cancer patients get Palliative care? This is often the question posed by many patients and family members with other terminal illnesses such as Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), or neurological diseases with difficult to manage symptoms. The fact is, end-stage COPD typically results in debilitating dyspnea, poor quality of life, and increased morbidity and mortality. Patients frequently require several hospital admissions a year for relief of acute exacerbation of COPD symptoms. This negatively impacts patient’s quality of life as they enter the final chapters of their life. Additionally, COPD sufferers become increasingly homebound with limited mobility and ever reliant upon family members to assist with everyday care and ADLs.

Palliative care has been proven to improve perceptions of quality of life and decrease health care costs to patients with terminal cancer. The same positive influence can be utilized in those with end stage COPD, CHF, or any terminal illness. Unfortunately, patients suffering from these conditions typically are not as prepared to face end-of-life decisions, discuss dying, or prepare for death with family members in comparison to those same patients entering the end stages of cancer. This has as much to do with the unwillingness of patient’s to engage in end-of-life care planning, as it does the uncertainty of general practitioners to relay poor prognostic features of the disease or shrinking survival rates.

Palliative Care can be of great assistance in this setting by providing holistic care, active listening to fears, anxiety, and concerns of the patient and family members alike, improve perceptions of quality of life, and assist in end-of-life preparation. Palliative care’s role in symptom management for the end stage COPD patient is crucial in regaining modest amounts of self care, facilitate energy conservation, and maximize function.


Amy Lunsford, RN, MSN, ACNP
Palliative Care Nurse Practitioner

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