Palliative care is becoming a more accepted and practiced part of a patient’s treatment across the US. The benefits are proven, and more hospitals are incorporating it into their treatment plans. However, there are still many bridges to cross and obstacles to overcome before it’s considered standard. One area that needs improvement is cardiac care.
How palliative care can help
Palliative care is providing services that meet the patient’s desires and needs to give them a high quality of life as they undergo treatment for serious illness. The goals are to make the medical experience as pain-free as possible, give support to the patient, provide a multidisciplinary team to coordinate care, and keep the patient positive. Studies have shown that using palliative care reduces symptoms in patients and give them a higher quality of life. This all goes on while the patients deals with a serious illness.
Cardiovascular disease and palliative care
Cardiovascular disease affects millions of people worldwide and accounts for over 17 million deaths annually, more than 30% of the total – the number one cause of all deaths worldwide. The disease itself can be very stressful for patients and their families, with strong symptoms such as labored breathing, chest pain, dizziness, fatigue, heartburn, and abdominal pain. The timeline for the disease is also generally unclear, which can increase the stress and the emotional turmoil for the patient. For these reasons, heart disease is a prime choice for palliative care, and both the American Heart Association and the American College of Cardiology support incorporating it into cardiac care.
Despite the evidence and the recommendations, at this point, doctors treating heart disease overwhelmingly decline the offerings of palliative care for cardiac patients. A study seen in the JAMA open network shows that physicians rarely prescribe a palliative program for heart patients, and if they do, it’s at the very end of life.
Encouraging doctors to offer palliative care
Diane Meier, MD, the director of the Center to Advance Palliative Care, offers a protocol to help cardiologists navigate bringing palliative care into their practices. She recommends that patients should be considered for palliative treatment if they meet any of these criteria:
- They have more than one hospital admission
- They have symptoms that are unmanageable
- Their home or social setup is unsafe for them
- Their cognitive and functional abilities have decreased.
People who are severely ill and have lost some function and have been hospitalized or stayed in a facility have a 47% chance of being readmitted to a hospital and a 28% chance of dying over the next year. People in this situation need an extra dose of support, physically, psychologically, and emotionally, to deal with their symptoms and make it through rounds of their illnesses.
Making it work practically
Dr. Meier offers practical suggestions for patient evaluations, with easy to use assessment tools already in existence. Patients can fill them out on tablets in the waiting room, and the information can be directly uploaded to the patient’s Electronic Health Record (EHR). even better, patients can report symptoms through their smartphones, and alerts can be triggered so doctors and immediately recommend the extra layer of care when they need it.
Palliative care training
There are multiple resources for doctors to get training in palliative care, some through their members organizations (AHA, ACC) and others through palliative care specialist organizations.
At Hudson View Center for Rehabilitation in Bergen County, New Jersey, we integrate palliative care measures with our cardiac care so patients can have enhanced quality of life while they undergo treatment.