Living with serious illness can be overwhelming. Apart from coping with physical pain and the side effects that may accompany medical treatment, patients may be consumed by a variety of non-medical concerns related to the illness. The Palliative Care Program provides care for patients and their loved ones by managing pain and other symptoms, but also by listening, and by offering various kinds of support. At NewYork-Presbyterian Brooklyn Methodist Hospital, palliative care is provided by a team that includes physicians, nurses, social workers and chaplains, as well as dieticians, psychologists and physical therapists.
The patient's comfort begins with the control of physical pain. A comprehensive approach to the management of intractable pain includes both medication and the use of new interventional techniques that block pain at the source, thus reducing the need for opioid drugs. Complementary treatments, such as meditation and yoga, may also be used. In treating patients, pain management specialists strive not only to decrease the intensity and frequency of the pain but also to decrease the use of potent analgesic drugs whenever possible, and to help patients understand the link between pain and emotional well being.
Pain management and palliative care are not the same as hospice or end-of-life care, with which it is often confused. Physicians and surgeons at NewYork-Presbyterian Brooklyn Methodist Hospital are encouraged to contact and request a consultation from the Pain Management or Palliative Care Team, if their patients are in physical or emotional pain. This allows the team to make the patient more comfortable in every way, so that he or she is more likely to complete treatment successfully.
However, palliative care is not a substitute for curative therapy. Doctors and other clinicians continue to treat a patient's illness or injury, except in hospice situations when the focus shifts solely to symptom relief and psychosocial support.
When physical pain and symptoms are well-managed, the team can deal with what they call "existential" issues, which may include anything from spiritual support by a chaplain to practical assistance with finances. All issues, medical and non-medical, are addressed in meetings between the team, the patient and the patient's loved ones. In these meetings, goals are explored and a plan of care devised.
Depending on the severity of the patient's illness, this might also involve end-of-life arrangements, including assignment of an agent to act on the patient's behalf and preparation of a living will. If options for treating a patient's disease have been exhausted, palliative care shades into hospice care: pain management and emotional support either in the Hospital or at home.