Palliative medical care is a balancing act

Over 20 years ago, my superstitious mother feared that if she and dad made out a will, that might cause them to die sooner.

Irrational, yes, but somehow real to her. We eventually convinced them to get the will. (They didn’t die for some years after.) Superstitions are usually based on misinformation, aren’t they.

I feel that misinformation is present today when it comes to a fairly new sub-specialty of medical care called palliative care medicine. I also suspect superstitions about end-of-life matters contribute to the “mystery” of palliative care.

It really isn’t a mystery! It simply isn’t well-known yet.

Simply and directly stated, palliative care is a specialized medical approach that helps improve quality of life without necessarily abandoning curative treatment. In fact, we have a friend who is in a clinical trial for her pancreatic cancer and is also under the care of a palliative care doctor.

And she is very thankful for that care, even as she and her husband are literally fighting for her life.

Her situation is one expression of how palliative care can support a personal/family decision regarding her disease. Another person or family may choose another decision entirely.

So in a real sense, palliative care becomes a balancing act for both doctor and patient. Dr. Isaac Chan, a medical oncology fellow at John Hopkins Hospital in Wash-ington, D.C., wrote of this balancing act in an opinion piece in a recent issue of The Washington Post.

One patient underwent significant and painful side-effects of his cancer treatment. But he chose to continue the treatment. Dr. Chan struggled to balance his patient’s determined wishes with his medical opinion that palliative care could improve the man’s life. Balance tends to lean toward the patient.

Another balance challenge is about when palliative care might become hospice care. We may easily confuse the two.

Palliative care focuses on symptom control of a medical condition and side effects of treatment. Community services, finances, caregiver support also occur.

Hospice care includes palliative care for relief of pain and other symptoms plus the other services mentioned above. However, it is reserved for persons whose diagnoses suggest they have six months or less to live, and no longer receive curative treatment.

Both modes of care include end-of-life conversation between the care team members and a patient and family. But there is likely a different sense of urgency to those conversations with a hospice family.

Do you have some deeper curiosity to learn more about how palliative care provides tries to improve the quality of living for an individual and that person’s family?

Then please join us next Tuesday, Nov. 27, at our 2:30-4 p.m. Geezer Forum in the Columbia Bank’s Community Room.

Dr. Nicole Pelly, outpatient palliative care physician with the Kootenai Clinic Palliative Care, will be our resource speaker. Dr. Pelly clearly understands her medical specialty; but as importantly, she intuitively and compassionately understands the persons under her care.

Her approach to palliative care focuses on all aspects of who her patient might be. She works with other team members to take into account a person’s needs and a family’s needs

If you can join us next Tuesday afternoon at the Geezer Forum, I believe you will discover that palliative care is a medical service you might even look forward to receiving if you find yourself with a serious, even life-threatening, diagnosis. Please join us!

Paul Graves, M.Div., is lead geezer-in-training of Elder Advocates, a consulting ministry on aging issues. Contact Paul at 208-610-4971 or at elderadvocates@nctv.com.