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"Relieves Suffering from Symptoms and Stress"

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"Relieves Suffering from Symptoms and Stress"

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According to getpalliativecare.org - symptoms related to palliative care include:

pain

depression

shortness of breath

fatigue

constipation

nausea

loss of appetite

sleeping issues

anxiety

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Definition of Palliative Care

Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.

Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient's other doctors to provide an extra layer of support. Palliative care is based on the needs of the patient, not on the patient's prognosis. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

Palliative Care Improves Quality of Life

Palliative care teams focus on quality of life. They treat people suffering from the symptoms and stress of serious illnesses such as cancer, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), kidney disease, Alzheimer's, Parkinson's, Amyotrophic Lateral Sclerosis (ALS), and many more.

Relieves Suffering From Symptoms and Stress

The goal of palliative care is to relieve suffering and provide the best possible quality of life for patients and their families.Symptoms may include pain, depression, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping, and anxiety. The team will help you gain the strength to carry on with daily life. In short, palliative care will help improve your quality of life.

And recent studies, including one published in the New England Journal of Medicine, have shown that patients with a serious illness who received palliative care lived longer than those who did not receive this care.

Helps You Match Treatment Options to Your Goals

The palliative care team also spends the time it takes to help you match your treatment choices to your goals. They will also make sure that all of your doctors know and understand what you want. This gives you more control over your care and will improve your quality of life.

Works Together with Your Other Doctors

Palliative care teams are specialists who work together with you, your family and your other doctors. They provide an extra layer of support when you need it most. In addition to treating your symptoms and stress and supporting you and your family, the palliative care team communicates with all of your doctors so that everyone is on the same page. They support you every step of the way.

How to Get Palliative Care

If you or a loved one is facing a serious illness, you may benefit from palliative care. You can have palliative care at any point in your illness. Search the Palliative Care Provider Directory to find it near you. Take the quiz if you're not sure. Then speak to your doctor, and ask for it. Bring the handout with you!

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What is Palliative Care? The definition of palliative care is medical care that relieves pain, symptoms and stress caused by serious illness.

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From the National Institute on Aging.

"Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart failure. Patients in palliative care may receive medical care for their symptoms, or palliative care, along with treatment intended to cure their serious illness. Palliative care is meant to enhance a person's current care by focusing on quality of life for them and their family."

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Many Americans die in facilities such as hospitals or nursing homes receiving care that is not consistent with their wishes. It's important for older adults to plan ahead and let their caregivers, doctors, or family members know your end-of-life preferences in advance. For example, if an older person wants to die at home, receiving end-of-life care for pain and other symptoms, and makes this known to health care providers and family, it is less likely he or she will die in a hospital receiving unwanted treatments.

If the person is no longer able to make health care decisions for themselves, a caregiver or family member may have to make those decisions. Caregivers have several factors to consider when choosing end-of-life care, including the older person's desire to pursue life-extending treatments, how long he or she has left to live, and the preferred setting for care.

What is palliative care?

Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart failure. Patients in palliative care may receive medical care for their symptoms, or palliative care, along with treatment intended to cure their serious illness. Palliative care is meant to enhance a person's current care by focusing on quality of life for them and their family.

Who can benefit from palliative care?

Palliative care is a resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia, Parkinson's disease, and many others. Palliative care can be helpful at any stage of illness and is best provided soon after a person is diagnosed.

In addition to improving quality of life and helping with symptoms, palliative care can help patients understand their choices for medical treatment. The organized services available through palliative care may be helpful to any older person having a lot of general discomfort and disability very late in life.

Who makes up the palliative care team?

A palliative care team is made up of multiple different professionals that work with the patient, family, and the patient's other doctors to provide medical, social, emotional, and practical support. The team is comprised of palliative care specialist doctors and nurses, and includes others such as social workers, nutritionists, and chaplains. A person's team may vary based on their needs and level of care. To begin palliative care, a person's health care provider may refer him or her to a palliative care specialist. If he or she doesn't suggest it, the person can ask a health care provider for a referral.

Where is palliative care provided?

Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home. Medicare, Medicaid, and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance might pay for some services. Health insurance providers can answer questions about what they will cover.

Visit the National Hospice and Palliative Care Organization website to find palliative care near you.

Adriana's story

Adriana developed anemia while she was being treated for breast cancer. A palliative care specialist suggested she get a blood transfusion to manage the anemia and relieve some of the fatigue she was experiencing. Controlling her symptoms helped Adriana to continue her curative chemotherapy treatment. Treating her anemia is part of palliative care.

In palliative care, a person does not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. Over time, if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities. Palliative care could transition to hospice care if the doctor believes the person is likely to die within six months (see What does the hospice six-month requirement mean?). Or, the palliative care team could continue to help with increasing emphasis on comfort care.

For more information, check out NIA's article on Frequently Asked Questions About Palliative Care.

What is hospice care?

Increasingly, people are choosing hospice care at the end of life. Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life.

At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. Hospice is designed for this situation. The patient beginning hospice care understands that his or her illness is not responding to medical attempts to cure it or to slow the disease's progress.

Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person's illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.

It's important for a patient to discuss hospice care options with their doctor. Sometimes, people don't begin hospice care soon enough to take full advantage of the help it offers. Perhaps they wait too long to begin hospice and they are too close to death. Or, some people are not eligible for hospice care soon enough to receive its full benefit. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones.

Where is hospice care provided and who provides it?

Hospice is an approach to care, so it is not tied to a specific place. It can be offered in two types of settings - at home or in a facility such as a nursing home, hospital, or even in a separate hospice center.

Read more about where end-of-life care can be provided.

Hospice care brings together a team of people with special skills - among them nurses, doctors, social workers, spiritual advisors, and trained volunteers. Everyone works together with the person who is dying, the caregiver, and/or the family to provide the medical, emotional, and spiritual support needed.

A member of the hospice team visits regularly, and someone is usually always available by phone - 24 hours a day, seven days a week. Hospice may be covered by Medicare and other insurance companies. Check to see if insurance will cover the person's particular situation.

Dolores' story

Choosing hospice does not have to be a permanent decision. For example, Dolores was 82 when she learned that her kidneys were failing. She thought that she had lived a long, good life and didn't want to go through dialysis, so Dolores began hospice care. A week later, she learned that her granddaughter was pregnant. After talking with her husband, Dolores changed her mind about using hospice care and left to begin dialysis, hoping to one day hold her first great-grandchild. Shortly after the baby was born, the doctors said Dolores' blood pressure was too low. At that point, she decided to re-enroll in hospice.

It is important to remember that stopping treatment aimed at curing an illness does not mean discontinuing all treatment. A good example is an older person with cancer. If the doctor determines that the cancer is not responding to chemotherapy and the patient chooses to enter into hospice care, then the chemotherapy will stop. Other medical care may continue as long as it is helpful. For example, if the person has high blood pressure, he or she will still get medicine for that.

For more information about hospice and palliative care

NIA Alzheimer's and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
The NIA ADEAR Center offers information and free print publications about Alzheimer's and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

Alzheimers.gov
www.alzheimers.gov
Explore the Alzheimers.gov website for information and resources on Alzheimer's and related dementias from across the federal government.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

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What Are Palliative Care and Hospice Care?

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Learn about options for care at the end of life and the difference between hospice and palliative care.

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Video gives a basic understanding of what Palliative care is and who is it for.

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Palliative care can start at diagnosis and can be concurrent with treatment for a disease.
(Nathan Adelson Hospice)

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Hospice Learning Center - Nathan Adelson Hospice

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Palliative Care - How is palliative care different from hospice care?

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A nurse's take on what Palliative Care is.

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A nurse's take on what Palliative Care is.

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Video explains why she went into pediatrics and what her work means to her.

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A nurse practitioner's Brief But Spectacular take on end-of-life care for children

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Various Perspectives on What Palliative Care Is.

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Various Perspectives on What Palliative Care Is.

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Everyday people talk about perspectives on palliative care.

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Australian Department of Health and Aged Care

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Palliative Care - Talking about what matters

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According to NurseJournal.org., palliative care nurses help to monitor pain, administer pain medication, provide emotional support, and help educate the patient and family members. It also discusses where palliative care nurses work: hospitals, home care, and hospices.

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Palliative care offers registered nurses (RNs) a challenging but highly rewarding career providing compassionate care to patients and their families during very difficult times. Palliative care nurses help relieve pain, and they extend comfort and support to critically ill patients or those nearing the end of their lives. These RNs also assist patients and their families with care plans and end-of-life decisions.

As the U.S. population ages, a growing number of patients will require the skills and services of palliative care nurses. These nursing specialists can expect to find employment opportunities in numerous settings, such as hospitals, assisted living facilities, hospices, and private homes.

Discover what a palliative care nurse does and how to become one.

What Does a Palliative Care Nurse Do?

Nurses who specialize in palliative care provide short-term or long-term services. They offer curative care to critically ill patients or relief and comfort for the terminally ill. They also support families, providing practical advice and bereavement care.

Palliative care nurses work with patient populations across the life span. Patients encompass a broad range of persistent, critical, or recurring medical conditions that restrict daily life or reduce life expectancy.

While often working with the elderly, these RNs may provide care for patients of all ages diagnosed with conditions such as cancer, kidney failure, cardiovascular disease, or dementia. They also care for patients with life-threatening injuries or those living with disabilities dependent on assistive care.

JGI/Tom Grill / Getty Images

Where Do Palliative Care Nurses Work?

Palliative care nurses find employment in several healthcare environments that serve critically ill patients, the elderly, and those in the end stages of life. While hospitals, assisted living facilities, and nursing homes are among the most common employers, they also work in veterans' homes, correctional facilities, and mental health clinics. A growing number of these RNs work in outpatient settings, including specialized palliative care clinics and home care.

How to Become a Palliative Care Nurse

If you are interested in becoming a palliative care nurse, you must first become a registered nurse. You must earn either an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). Once you complete your nursing degree, you must pass the National Council Licensure Examination for RNs (NCLEX-RN) to apply for an RN license in the state where you intend to practice. While RNs can enter the field with an ADN degree, many employers prefer to hire BSN-holders.

After finishing your nursing degree and getting your RN license, you should have at least two years of clinical experience working in an acute care or a critical care setting, such as a hospital emergency room or intensive care unit. This will help develop the nursing skills and coping mechanisms you need to work in a palliative care environment.

While an RN license provides validation of general nursing care, getting a specialized certification in palliative care nursing demonstrates a higher level of expertise and professional commitment. It can lead to greater career and salary opportunities.

The Hospice and Palliative Credentialing Centeroffers several hospice and palliative certification options for registered nurses and advanced practice nurses. RNs may pursue certifications as advanced certified hospice and palliative nurses, certified hospice and palliative nurses, and certified hospice and palliative pediatric nurses.

How Much Do Palliative Nurses Make?

The rapid growth of the aging population and the increasing public acceptance of palliative measures for seriously and terminally ill patients drive the demand for palliative care nurses. The U.S. Bureau of Labor Statistics projects the employment of all RNs, including palliative care nurses, to grow by 9% between 2020 and 2030. In May 2021, RNs earned an hourly wage of $39.78, or an average annual salary of $82,7500, well above the average annual wage of $58,260 for all occupations.

While entry-level salaries for palliative care nurses may be similar, RNs with BSN or graduate degrees and certifications can achieve higher salaries and greater opportunities for career advancement. In addition to educational background, earning potential for palliative care nurses depends on the type of employer, geographical location, and years of experience.

Frequently Asked Questions about Palliative Care Nurses

How long does it take to become a palliative care nurse?

Most students take between 2-4 years to earn a nursing degree, followed by completion of the NCLEX-RN exam. RNs interested in palliative care careers should also expect to spend a minimum of two years getting clinical experience in acute care or critical care healthcare settings.

What's the difference between a palliative care nurse and a hospice?

Hospice care provides comfort and support without offering curative measures to patients expected to live six months or less. Hospice patients may no longer have curative options available or may have chosen not to pursue further treatment.

Palliative care includes both curative and noncurative support for patients with serious illnesses or disabilities, no matter their diagnosis or the stage of their condition.

What skills are important for palliative care nurses?

In addition to general medical knowledge and palliative nursing skills, these nurses must be keen observers and critical thinkers. Palliative care nurses must function in stressful conditions, caring for diverse patient populations with compassion and empathy.

What is included in palliative care?

Palliative care provides relief from symptoms and stress for seriously ill or terminally ill patients. Palliative care RNs may offer physical, mental, emotional, and spiritual support to patients and their families. Patients may receive palliative care at any stage in their illness, with or without curative treatments, based on their needs rather than their prognosis.
Page last reviewed August 4, 2022

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Palliative Care Nurse Career Overview | Nursejournal.org

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Want to learn more about a career in palliative care nursing? Explore how to become a palliative care nurse, work settings, and salary prospects.

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Nursing’s role in leading palliative care: A call to action - PMC (nih.gov)

This article from NIH.gov discusses the need to have a holistic approach to care for the patient and their family. It also mentions the importance of nurses and their ability to discuss what palliative care is for everyone involved.

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Skills for Nurses to have in Palliative Care

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Skills for Nurses to have in Palliative Care

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This article looks at career traits-skills for nurses to have when working in palliative care. Skills relate to:

Pain and symptom management

End-stage disease processes

Psychosocial

Spiritual and culturally sensitive care of patients and their families

Interdisciplinary collaborative practice

Loss and grief issues

Patient education and advocacy

Bereavement care

Ethical and legal considerations

Communication skills

Ability to handle stress

Compassion and empathy

Awareness of community resources

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Palliative care is the medical specialty focused on people living with serious illnesses and providing relief from the symptoms and stress of a serious illness.

The goal of palliative care is to improve the quality of life for both the patient and the family, and is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

Palliative care is appropriate for anyone suffering from a serious illness, such as: ¹

Cancer

Cardiac disease

Respiratory disease

Kidney failure

Alzheimer's

AIDS

Amyotrophic lateral sclerosis (ALS)

Palliative care to patients can be initiated from the point of diagnosis and is not dependent on prognosis.

Nurses who work in palliative care are specially trained to deal with complex pain and symptoms, as well as communication about serious illness and treatment plans, supporting the patient in areas of:

Nurses who work in palliative care work to improve a patient's ability to tolerate medical treatments and allow the patient to have more control over their care by improving their understanding of treatment options and matching their goals to those options. The Palliative Care Nurse also helps support family caregivers and provides practical support.

Training for Palliative Care Nursing

Palliative Care Nurses work in collaboration with other health providers, such as physicians, social workers, and chaplains, within the context of an interdisciplinary team.

Composed of highly qualified, specially trained professionals and volunteers, the team blends their strengths together to treat a variety of symptoms. Palliative care may be part of lifelong treatment, or it may be short-term in the case of a terminal illness.

In this instance, the care team will anticipate and meet the needs of the patient and family facing terminal illness and bereavement, which is why palliative care and hospice, or end-of-life care, often get grouped together.

Palliative Care Nurses can play a role in end-of-life care. To accomplish this, nurses collaborate in a cultural assessment of the patient and family and provide culturally sensitive care.

Although the majority of Palliative Care Nurses are "generalists," some elect to sub-specialize in areas of oncology, pediatrics, or geriatrics and pursue advanced practice credentialing. Certification for nurses practicing in palliative care as a Certified Hospice and Palliative Nurse (CHPN) has been available since 1999, following the initial development of the Certified Nurse Hospice (CRNH) in 1994.

There is a distinct body of knowledge with direct application to the practice of palliative care nursing. In addition, there are particular career traits that are valuable in a palliative care nurse. This includes:

Pain and symptom management

End-stage disease processes

Psychosocial

Spiritual and culturally sensitive care of patients and their families

Interdisciplinary collaborative practice

Loss and grief issues

Patient education and advocacy

Bereavement care

Ethical and legal considerations

Communication skills

Ability to handle stress

Compassion and empathy

Awareness of community resources

Palliative Care Nurses are registered nurses prepared at the associate degree, baccalaureate degree, and/or master's-degree level. This can take 2 to 4 years, or longer. Let's dive a little deeper into what a palliative care nurse actually does.

What Does a Palliative Nurses Do?

Palliative care nurses provide a wide range of general nursing tasks for patients. This can be either short-term or long-term care for critically ill individuals.

What a patient can receive from a palliative care nurse include:
Medication Administration
Under a doctor's prescription, nurses give patients some medications. Medication dosages and delivery techniques, such as syringes or oral medications, call for a thorough understanding.
General Care
In addition to checking and documenting vital signs, nurses also provide basic care such as maintaining patient hygiene, helping patients with daily tasks like getting dressed or eating, and reporting to the patient's primary care physician.
Offer Comfort
Nurses are able to provide a professional form of support and comfort. They can listen to the patient's worries and concerns, help explain the patient's condition or symptoms, and communicate with the patient's family.
File Necessary Paperwork
Medical paperwork and documentation that patients may need assistance with include medical documents, prescriptions, and all physician orders.
Keep Families and Patient Informed
Nurses must keep a close relationship with the patient's family and inform them of any changes in their health, their illness trajectory, along with existing treatment plans and care. Palliative nurses must also be available and knowledgeable regarding any questions the family may have.
Assist in Pain Releif
The ultimate goal is comfort and pain management for these patients. Nurses must carefully monitor pain levels and offer solutions to avoid discomfort. This can include physical pain, nausea, bed sores, anxiety, and difficulty breathing.

Where Do Palliative Nurses Typically Work?

There are three main locations where a palliative care nurse will typically work. That includes:

Palliative Home Care

Private home palliative care nurses visit patients at their homes or temporarily occupy them to offer one-on-one care. Patient care may include administering medication, general nursing care, developing treatment plans, and more. Additional duties, such as meal preparation or simple daily tasks like taking out the garbage, may also be included.

Hospice Palliative Care

Hospice settings are intended for end-of-life care for patients that typically have 6 months or less to live. Therefore, nurses are not offering curative care and treatments. Instead, the high quality of care is intended to make patients with life expectancy of less than 6 months as comfortable and relaxed as possible and address emotional needs.

Palliative Nurse Care at Hospitals

These nurses work together with doctors, other nurses, and healthcare professionals as a part of the hospital's medical team to offer curative treatment to seriously ill patients and comfort and support to terminally ill patients. This can be a long-term or acute care setting.

How Much do Palliative Nurses Make?

With the increasingly aging Baby Boomer generation, the need for palliative nurses is growing each year. This provides an excellent outlook for RNs looking to pursue palliative care services.

As of 2023, the average salary for an RN in the United States is about $93,500.

Stress on the Palliative Care Nurse

In general, nursing is recognized as an occupation that is associated with stress on both professional and personal levels.

Because of the nature of their patient's advanced needs, health care providers may experience stressful situations related to death and dying-though they do not experience it as often as Hospice Care Nurses. However, the nursing literature suggests that stress and its effects can be moderated in these nurses through personal coping strategies and social support. ⁴

In general, it has been found that the levels of stress and distress experienced by Palliative Care Nurses were no greater than those experienced by nurses from other specialties. In addition, nurses must stay updated on palliative care education.

Palliative Care Nurses who are well-trained and experienced may be at less risk of psychological distress and burnout than other nurses, because they may better utilize self-care strategies to reduce work-related stress which they have also taught to their patients and their families.

Because of the advanced training and experience required for Palliative Care Nursing, both clinical nursing skills and relationships with patients were seen as important, and these relationships has been found to reduce nurses' experiences of stress.

Given the breadth of skills required to perform in this role, well-prepared Palliative Care Nurses may have ways of coping with the stress of their work environment that mitigate their stress levels. 5

One of the most common stress-reduction strategies used by Palliative Care Nurses includes informal gatherings of staff and weekly meetings that featured reflective discussions to help nurses in their professional development, allowing for both interaction of what they are dealing with and someone who understands can listen, advise, and console. ⁶

Benefits of Palliative Care Nursing

In addition to the comfort, care, and support that the Palliative Care Nurse offers to a patient and his or her family, there are several health and economic benefits that have been found when Palliative Care is undertaken by a patient:

Lung cancer patients receiving early palliative care had less depression, improved quality of life and survived 2.7 months longer⁷

Patients with a Palliative Care Nurse demonstrated significant reductions in pharmacy, laboratory, and intensive care unit costs⁸

Patients who died under Palliative Care Nursing Support for a specific illness have a cost savings of $4,908 per hospital admission when compared to patients for these same illnesses who did not receive Palliative Care Nursing support⁹

Palliative care patients who were discharged alive had a net savings of $1,696 per admission, in comparison to matched cohorts of comparable patients who received usual care¹⁰

The Need for the Palliative Care Nurse

Palliative care is a model that is consistent with basic nursing values, which include caring for patients and their families regardless of their age, culture, socioeconomic status, or diagnoses, and engaging in caring relationships that transcend time, location, and circumstances.

Palliative Care Nurses address the complexity of patient and family needs and serve as cost-effective medical care coordinators for patients and families with both chronic and life-limiting illnesses, to reduce suffering and improve the quality of living and dying across the lifespan. ¹¹
If you are looking for a private duty nurse for palliative care for yourself or a loved one, click here to learn more. Or, call (650) 462-1001 to speak with a Client Care Coordinator.
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References

⁷ Meier, Diane, "CAPC Facts and Figures," Center To Advance Palliative Care, 2014.

¹¹ Prevost, S., "Palliative and End-of-Life Care Transformation Models of Nursing Across Settings," The Future of Nursing: Leading Change, Advancing Health, 2011, National Academies Press.

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Nurses in Palliative Care | NurseRegistry Healthcare Blog

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Palliative care focuses on providing comfort and relief to people living with serious illnesses. Find out about Palliative Care Nurses here.

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Palliative Care in Cancer - NCI

The National Cancer Institute discusses issues that can be addressed in Palliative care including:

Physical needs

Emotional needs

Spiritual

Caregiver issues

Practical needs that relate to financial and legal worries.

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Shortness-of-Breath (getpalliativecare.org)

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Palliative Care and Disease Types | Get Palliative Care

Informative list that provides information as to how palliative care can help with a specific disease.

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Discusses how to find a support group and how siblings can be supportive.

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Palliative Care for Children and Supporting the Family

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Palliative Care for Children and Supporting the Family