What is palliative care and when do you need it?

Dr Michelle King highlights that palliative care should start from the time you are diagnosed and added to that, it is classified as a prescribed minimum benefit (PMB).

Palliative care is specialised medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.

It’s provided by a specially-trained team who work together with a patient’s other doctors to provide an extra layer of support. Palliative care is based on the needs of the patient, not on the patient’s prognosis. It’s appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

When does it start?

Ideally you should be referred to a palliative care team from the time you’re diagnosed with cancer. These are healthcare professionals, for example, care workers, nurses, doctors, social workers, psychologists, who have received specialised training in palliative care. 

Palliative care is an additional layer of support, and the team works alongside your doctor or oncologist to assist in providing the best possible care and support. 

How does it help?

The team are there to assist you and your family in navigating this difficult journey. The focus of care will be about what you need in order to live your life to the fullest, despite your diagnosis. Your treatment plan is individual and is focused on what your needs, values and personal goals are. 

Palliative care providers recognise that a diagnosis of cancer doesn’t only affect you but the people that love and care for you too. Assisting them is seen as an extension of caring for you.  

The support they provide may include helping you to tell your children that you’re diagnosed with cancer or assisting you in creating an end-of-life plan. Your palliative care team will continue to support your family in their bereavement after your death too. 

Their specialised training enables them to provide you with emotional support. For example, dealing with depression and anxiety as well as spiritual support. They can help manage the difficult physical symptoms too, such as fatigue, nausea and vomiting, pain, shortness of breath and constipation. 

There may be times when you need help to find answers to the tough questions that you have but don’t know how to ask your doctor. Even if you decide not to have treatment, such as chemotherapy or radiotherapy, your palliative care team will be there to support you and help you in achieving the goals of care that you want. 

Early referral is key

An early referral to palliative care services can have a significant improvement in terms of reducing your suffering and prolonging your life. 

Many doctors aren’t aware of the specialised services that palliative care teams provide and as a result don’t refer you until they have exhausted all medical treatments (and sometimes they don’t refer at all). You may need to be your own advocate and ask to be referred to a palliative care specialist. 

The Temel Study

There was a big study, The Temel Study, which was done in the UK in 2010. The researchers investigated the impact palliative care had on patients who had been diagnosed with metastatic lung cancer. The results showed that patients who received palliative care alongside their usual care had a significant improvement in quality of life and mood and they lived longer compared to patients who didn’t receive palliative care.

Did you know palliative care is a PMB?

Palliative care falls under a prescribed minimum benefit (PMB) treatment so your medical aid should be providing cover for it by law, but not all medical aids do. 

One large medical funder does, but only for end-of-life care. Four other medical aids offer cover for palliative care from the time of diagnosis and have a good palliative care programme in place. 

If you are the type whose strength lies in advocacy, please encourage your medical aid to get on board and provide you with palliative care benefits in addition to your oncology benefits.

Dr Michelle King

MEET THE EXPERT – Dr Michelle King

Dr Michelle King qualified as a psychiatrist in 2007. Since then she has completed post-graduate diplomas in chronic pain management and palliative medicine, both through UCT. She is part of an interdisciplinary pain clinic and palliative care team. Dr King believes in empowering people so that they can take charge of their physical and mental health, and as a result, live their lives to the fullest.

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