Living with a life-limiting condition can affect all aspects of one’s well-being. Not only that, but it puts a lot of strain on the rest of the family and the primary caregiver.
If your loved one has a serious illness, you may have noticed that they face a range of physical, emotional, and practical limitations. Of course, the specific limitations can vary widely depending on the type and stage of the illness.
Challenges People With Serious Illnesses Often Face
Some of the physical limitations include
- decreased mobility,
- fatigue, and
- chronic pain.
Progressive illnesses can often lead to a decline in one’s physical abilities, making it difficult for your beloved to move around independently.
At the same time, chronic fatigue impacts their energy levels and daily functioning, while constant pain affects overall comfort and quality of life.
Treatments such as chemotherapy or other interventions, on the other hand, may have side effects that impact daily life and well-being.
Together with the physical symptoms, your loved one may experience emotional and psychological challenges. Coping with the uncertainty of a life-limiting illness can cause feelings of sadness, anxiety, and depression to arise. Experiencing grief and anticipatory grief as they face the impending loss of life is also common.
Simultaneously, physical limitations and the impact of the illness on social activities can lead to isolation and loneliness.
The costs associated with medical care, medications, and potential loss of income can create financial burdens for your beloved and the whole family, and family members or friends providing care may experience emotional, physical, and financial strain.
Facing one’s mortality may lead to questions about the meaning and purpose of life and existential distress. Your senior beloved may need support to address spiritual concerns and find meaning in their experiences.
Seniors with life-limiting illnesses often find communicating their end-of-life preferences and wishes challenging, which may lead to potential conflicts and decision-making challenges. And as the illness progresses, they may become increasingly dependent on others for assistance with daily activities.
Supportive care, including palliative care and hospice services, can help address many of these challenges by focusing on improving the quality of life, managing symptoms, and providing emotional and spiritual support for both you and your loved ones.
Common Symptoms in Palliative Care
One of the main goals of the palliative care team is to alleviate the symptoms caused by the disease and its treatment.
According to one study of symptoms in seniors suffering from serious illness, 59 percent of all participants reported digestive problems, such as indigestion, nausea, and vomiting, and 56 percent chronic or constant pain.
Other symptoms addressed by palliative care could be shortness of breath, delirium, musculoskeletal problems, and others.
Addressing Digestive Problems
An underlying disease, side effects of treatments, or other factors often cause digestive issues. The primary aim of the palliative care team in managing digestive issues is to improve the patient’s comfort, quality of life, and overall well-being. To achieve this, palliative care specialists usually take the following steps:
- Assess and Identify
Palliative care teams conduct thorough examinations to identify the specific digestive issues the patient is facing. This may include blood work, physical exams, observations, and contacting other physicians involved in treating your loved one.
The most common symptoms are nausea, vomiting, diarrhea, constipation, abdominal pain, or difficulty swallowing.
- Prepare a Tailored Treatment Plan
Treatment plans are tailored to the individual needs and preferences of the patient. Palliative care takes into account the underlying causes of digestive problems. It also considers the interactions and the impact of other medications the patient is taking.
Typically, this plan’s essential parts include preventing dehydration and electrolyte deficiencies and addressing any abnormalities in the blood’s acidity.
Medications may be prescribed to manage specific digestive symptoms. Antiemetics may be used to control nausea and vomiting, although, sometimes, doctors may have to change these until the right antiemetic is established. Laxatives or stool softeners can help alleviate constipation.
- Dietary Guidance
Palliative care teams, including dietitians, guide dietary choices to help alleviate
- Hydration Support
Maintaining adequate hydration is essential for overall well-being. Palliative care teams will help your loved one tackle issues related to dehydration or fluid imbalances by digestive symptoms. Adjustments to the diet, such as small, frequent meals, specific food choices, or cutting down on spices and condiments, are often recommended to address specific concerns.offering support through oral hydration, intravenous fluids, or other appropriate means.
- Nutritional Support
Sometimes, digestive problems may impact your beloved’s ability to consume and absorb nutrients. In that case, palliative care may involve nutritional support, such as enteral (through a tube placed into the stomach) or parenteral (through a tube inserted into the veins) nutrition, to ensure the patient receives essential nutrients.
- Symptom Control
Focusing on controlling symptoms that contribute to digestive issues, palliative care will address pain, help your loved one manage their anxiety or stress, and provide support for other symptoms that exacerbate digestive problems.
- Psychosocial Support
Digestive problems can be genuinely debilitating for many and, as such, can have psychological and emotional implications. Palliative care teams offer psychosocial support, including counseling and emotional assistance, to help patients cope with the impact of digestive symptoms on their daily lives.
- Communication and Education
Open communication between healthcare providers, patients, and their families is essential. You, your loved one, and the whole family can receive information, resources, and education from the palliative care team about the nature of digestive problems, the expected course of symptoms, and available management strategies.
- End-of-Life Planning
In situations where digestive problems are severe and progressive, discussions about end-of-life planning, including goals of care and preferences regarding symptom management, are addressed within the framework of palliative care.
By providing tailored and compassionate care, palliative team specialists aim to enhance your loved one’s quality of life and alleviate distress associated with digestive issues.
Palliative Care for Pain Management
Pain management is a crucial aspect of palliative care. The goal is to alleviate pain and discomfort while considering the patient’s overall well-being. Similar to the digestive symptoms approach, here are some key elements of pain management in palliative care:
- Comprehensive Assessment
Palliative care teams conduct thorough assessments to understand the nature, intensity, and impact of the pain. This includes considering the physical, psychological, social, and spiritual aspects of your beloved’s experience.
- Individualized Treatment Plans
Pain management in palliative care is highly personalized. Treatment plans are tailored to each patient’s unique needs, preferences, and goals, taking into account the underlying disease, the nature of the pain, and any coexisting conditions and their treatments.
- Multidisciplinary Approach
A multidisciplinary team, which may include physicians, nurses, pharmacists, physical therapists, psychologists, and other specialists, collaborates to address the various dimensions of pain. This team approach ensures a holistic and well-rounded strategy for pain management.
- Medication Management – dosage and optimization
Medications are a cornerstone of pain management in palliative care. Opioid and non-opioid medications may be prescribed to relieve pain.
Medications are carefully monitored, and adjustments are made based on the patient’s response and any potential side effects. The goal is to find the optimal balance between pain relief and minimizing side effects.
- Non-Pharmacological Interventions
Complementary and alternative therapies, such as hot and cold therapy, acupuncture, acupressure, extracorporeal shockwave therapy, physical therapy, platelet-rich plasma therapy, and relaxation techniques, may be incorporated to enhance pain management together with the medication treatment plan.
- Emotional and Social Support
Addressing psychological and emotional aspects of pain through counseling, partaking in a community or support groups, and other psychosocial interventions can provide additional help to your loved one in coping with the emotional toll of chronic pain.
- Bringing the Whole Family on Board
The family should be educated about pain management strategies, including medication use, potential side effects, and non-pharmacological approaches. Forthcoming and constant contact between the healthcare team, the family, and your loved one ensures that the treatment plan aligns with the patient’s goals and preferences.
- Advance Care Planning
Discussions about advance care planning, including preferences for pain management at the end of life, are an integral part of palliative care. This assures that the patient’s wishes regarding pain management are known and respected.
- Continuous Reassessment
Pain management is an ongoing, fluctuating process. Palliative care teams regularly reassess pain levels and the effectiveness of the treatment, making adjustments as needed to provide optimal relief.
Palliative care emphasizes the importance of treating pain as a multifaceted experience, recognizing the impact it has on a person’s physical, emotional, and social well-being. The approach aims to balance pain relief with maintaining the patient’s overall quality of life and functioning.
Approach to Shortness of Breath Symptom
The approach to the management of dyspnea or shortness of breath in palliative care aligns with those applicable to other aspects of the care.
Finding the root cause
Identifying and addressing the root cause of dyspnea whenever feasible and appropriate for the patient is crucial. This encompasses interventions such as chemotherapy and radiotherapy within the patient’s physical condition.
Preventing further distress
Alleviate shortness of breath without introducing additional issues, such as side effects, interactions, or imposing social and financial burdens.
Simply put, the idea of proportionality means that palliative care specialists avoid treatments that cause more problems than they solve when trying to manage symptoms or extend life. It’s about finding a balance where the benefits outweigh the drawbacks for the best overall well-being.
- Assessing the effectiveness of treatment
Palliative experts need to evaluate the worthiness of a treatment considering your loved one’s prognosis and the potential adverse effects of invasive procedures. It is essential to weigh the benefits against the suffering for both the patient and their family.
- Facilitating Open discussions
Engage in open discussions about all viable treatment options, including the possibility of forgoing intervention for your loved one. This collaborative approach empowers your beloved to participate in decision-making to the greatest extent possible.
Managing Delirium
Delirium is a condition that causes sudden and severe confusion. During delirium, a person’s thinking and awareness become disorganized, leading to a rapid change in behavior. If your loved one experiences delirium, they may have trouble concentrating, may appear restless, and their thoughts might jump from one topic to another.
Delirium can be caused by various factors, such as
- serious illnesses,
- infections,
- medication side effects, or
- changes in the environment.
Palliative care teams manage a delirium diagnosis by addressing the underlying causes, providing supportive care, and aiming to enhance the patient’s comfort.
- Identify and Treat Underlying Causes
Specialists would conduct a thorough assessment to identify and address any reversible causes of delirium, such as infections, medication side effects, metabolic imbalances, or dehydration. Treating the underlying cause can help alleviate the condition, as delirium often has multiple contributing factors. A comprehensive evaluation considers medical, psychological, and environmental elements.
Symptom Management
Palliative care focuses on managing distressing symptoms associated with delirium, such as agitation, anxiety, and hallucinations. Medications may be used cautiously to alleviate symptoms, but the emphasis should be on minimizing side effects and carefully monitoring the patient’s response.
- Non-Drug Interventions
These are often implemented as a first-line approach and may include creating a calm and familiar environment, maintaining a regular daily routine, providing reassurance, and involving family members in the care process.
- Communication and Reorientation
Communication with the patient should be clear and calm. Your loved one will need to be regularly reoriented to their surroundings, time, and situation. Consistent and familiar communication can help reduce confusion and anxiety.
- Family Involvement
Engaging the family members in the care, informing them about the nature of delirium, involving them in the care planning process, and providing training and education can help them understand and manage the symptoms.
- Minimize Environmental Stimuli
People suffering from delirium benefit from a quiet, calming environment with minimal noise, limited disruptions, and adequate lighting. A structured and predictable environment can help reduce confusion and agitation.
- Hydration and Nutrition
The palliative team would address hydration and nutrition needs, as imbalances in these areas can contribute to delirium. They would encourage your loved one to drink liquids and consider intravenous fluids or nutritional support if necessary.
- Medication Review
Part of the palliative care role is reviewing the patient’s medications regularly to identify and manage drugs that may contribute to delirium. Adjustments to the medication regimen, such as dose reduction or discontinuation of certain medications, may be considered.
- Planning for the future
In situations where delirium is part of the end-of-life process, palliative specialists will initiate discussions about advance care planning. They will make sure that the patient’s goals of care and preferences for symptom management are documented and respected.
- Collaboration with Specialists
Working collaboratively with specialists, including geriatricians and psychiatrists, optimizes the management of delirium. Consultations with relevant healthcare professionals can provide additional expertise and support.
- Support and Information
A crucial role in the treatment is the education of healthcare providers, family members, and the patient about delirium, its potential causes, and the management strategies employed. Emotional support and guidance are essential for your loved one and their caregivers.
Delirium management in palliative care is individualized and requires ongoing assessment and adjustments to address the patient’s changing health needs. The goal is to provide compassionate care that improves your beloved’s comfort and considers their dignity while regarding their unique circumstances.
Your Takeaway
Palliative care is delivered by a multidisciplinary team of specialists who combine forces to alleviate your loved one’s symptoms, provide comfort, offer a dignified life, and help them make important decisions regarding their care.
This specialized care focuses on managing chronic pain, decreasing digestive symptoms, relieving dyspnea, and helping control delirium, all common symptoms for people battling various life-limiting diseases.
Entrusting a professional palliative care service such as Amy’s Eden can mean enabling your loved one to go through the challenges of the serious illness in maximum comfort, surrounded by compassionate and experienced specialists. Contact us today to request a free assessment and learn the options Amy’s Eden offers.
