Question

An 85-year-old man with New York Heart Association class IV heart failure, hypertension, and moderate Alzheimer's disease, who lives at home with his 84-year-old wife, arrives at his primary doctor’s office with complaints of worsening heart failure symptoms, including breathlessness, extreme fatigue, poor appetite, and continence problems. His wife is feeling overwhelmed with his declining health and worries when he is not able to catch his breath and will no longer eat the food she fixes for him.

a.       Is this man a candidate for palliative care?

b.      What is palliative care and how is it different from hospice care?

c.       What is the goal of palliative care and what interventions might be tried to achieve these goals.

Answer 1

A. Yes, the symptoms mentioned is the indication of palliative care as the man is suffering from all the complications of his primary disease condition.

B. The main goal of both the palliative and hospice care is to provide comfort and relive the pain and suffering, however the palliative care is given when the patient is diagnosed from certain disease condition and while the patient is receiving the treatment such chemotherapy and hospice care is when all the treatment has stopped working and there is no other way to treat the patient, it usually involves symptomatic treatment such as if patient is having pain then analgesics are administered.

C. Palliative care focuses on providing comfort to the patient, reliving the suffering and increasing the quality of life for patient and their family.

Interventions to achieve these goals :

• Reliving the pain with analgesics.
• Providing psychological support.
• Encourage to open up about the feelings by arranging a meeting with people with the same condition.
• Provide psychological support to the patients family as well.
• Maintaining patients personal hygiene.