What is Palliative Care?

Written By: Dr. Alexander Nesbitt , Medical Director of Susquehanna Hospice and Palliative Medicine

Despite the fact that the US healthcare system is one of the most advanced in the world, there is evidence of significant gaps or areas of weakness. One of these involves the care of patients with advanced disease such as cancer, heart or lung disease, dementia or others. Over the last 10 years, studies have shown that such patients often suffer from inadequately treated physical symptoms such as pain, nausea, shortness of breath, or confusion. Patients and their families often struggle with making difficult decisions about treatment options such as feeding tubes, ventilator use, or cardiopulmonary resuscitation. Often the patient and family report problems in communicating with the staff in our complex medical system, and consequently feel an inadequate understanding of the prognosis and expected outcome of the illness.

Palliative care is a developing specialty within medicine designed to address these problems. It involves an interdisciplinary team including a physician, nurse, social worker and chaplain, working together to address the needs of the patient and their family as they go through advanced illness. Unlike hospice, such team help is not limited to terminally ill patients, but is offered to anyone with advanced disease with appropriate needs. Also unlike hospice, palliative care can be given concurrently with any aggressive or curative treatment, no matter how complex or expensive. For example, a patient hospitalized for their chronic congestive heart failure, or another undergoing skilled nursing care for their fractured pelvis would NOT be appropriate for hospice care, but would be appropriate for assistance by the palliative care team if they and their family desired. Consultation by palliative care is ordered by the attending physician, and is reimbursed by insurances as any other consultative service would be.

Studies looking at outcomes show that symptoms are more effectively managed, patients and families report higher levels of perceived support and satisfaction, and care is more likely to be consistent with patient wishes when palliative care is involved. The palliative care consult service has been operational in Williamsport Hospital for over two years, and is being extended to certain nursing homes in the area who wish to participate in this service. 

Dr. Nesbitt is the Medical Director of Susquehanna Hospice and Palliative Medicine in Williamsport, PA.  He is Board Certified in Hospice and Palliative Medicine and works full-time overseeing hospice care. He can be contacted at 570-326-8040.

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