Integrating Palliative Care into Practice

Abstract

Practitioners in long-term care medicine are seeing an ever-increasing number of persons with chronic progressive illness who reside either at home or in a LTC setting (nursing facility, SNF, assisted living or residential care). As of 2001, 46% of all deaths in the United States occur in these settings. Accordingly, clinicians have advocated that palliative care practice can be generalized and applied to such patient populations [1]. A multidimensional model of successful aging despite chronic illness where disease and its physiological and functional limitations are offset by compensatory psycho-emotional and social interventions that result in emotional vitality, well-being, and engagement with life and spirituality has been set forth by some [2]. Such an approach to care embodies the true philosophy of palliative care. Palliative care can and should be integrated alongside the traditional treatment of disease, where disease-modifying treatments are not necessarily avoided if appropriate and congruent with patients’ goals of care. Such “total care” should be safe, effective, patient-centered, timely, efficient, and equitable, all consistent with the six aims of the Institute of Medicine 2001 report to improve health care in the United States.