“Everyone on this floor is palliative.”
My jaw dropped open as I processed what the nurse said. I scanned the hall, and saw elderly residents living life. A few sat in the dining room enjoying afternoon tea from china tea cups and chatting. One rushed, with her walker, to get to her memoir-writing class. A group knitted in the lounge.
Palliative? Of the 80 residents on the floor, only one or two remained in bed. How could these people be called palliative?
Yet, they were. The nurse had called it correctly. The problem came with my understanding of the term.
“Palliative” is not an immediate death sentence
The purpose of palliative care is to improve the quality of life for patients and their families facing a life-threatening illness. In many ways, it’s a new normal and can last for many years.
As elders age, caregivers can find themselves overwhelmed with multiple physical issues. Diabetes, heart disease, lung issues, reduced kidney function and impaired cognition are all common and some people are dealing with several serious issues. At some point, the medical community shifts its focus from curing, which is no longer possible, to maintaining with the highest quality of life.
Palliative care focuses on quality of life
Quality of life is a whole picture:
- physical–what can be done through medications, treatments such as physiotherapy, wound care etc. to give the person the highest function?
- emotional–what activities make their lives happy, fulfilled and give them purpose and meaning?
- social–what activities give elders a sense of community and foster friendships?
- spiritual–what brings a closeness to their spiritual roots, if they have them?
- family/friends support–this is often forgotten, but few elders live in a vacuum with no family or friends. When their health begins to deteriorate, those who love them need support in order to be able to walk through this season with them.
What matters in palliative care?
- Relief of pain and other physical side effects of disease as much as possible. An
example might be shortness of breath due to heart disease or lung issues. The doctor might address this through a diuretic medication or possibly ongoing oxygen. These won’t cure but will make the elder more comfortable. - Focus on life and finding the best possible, but sees death, not as the enemy but a natural process.
- Death isn’t hastened, but when it becomes evident that the body is shutting down, death isn’t unnecessarily postponed.
- Family and friends are an extension of the elder and need support as well.
Excellent palliative care ensures the best possible life for our elders throughout this period. What happens next?
Next week: End-of-life and how to recognize it
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