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Palliative Care for People with Respiratory Disease or Critical Illness

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Palliative Care for People with Respiratory Disease or Critical Illness

When you have a serious illness, you may suffer from physical discomfort, such as pain, difficulty breathing, nausea (stomach upset) or fatigue (tiredness). You may also have feelings of psychological distress, such as anxiety or depression, or feelings of spiritual distress. Your health care providers can offer medical therapies to manage your illness, for example, antibiotics to treat pneumonia. Your health care providers can also offer care that is focused on improving your quality of life and helping you feel more comfortable. This type of care is called palliative (PAL-lee-uh-tiv) care.

What is palliative care?

The World Health Organization (WHO) defines palliative care as an approach that improves the quality of life for patients and families facing life-threatening illness. People with serious lung problems or who are critically ill may suffer from symptoms of pain, breathlessness, or cough. Palliative care works to improve quality of life by preventing or relieving these symptoms and can also help with a person’s psychological, spiritual, or emotional needs.

When should I receive palliative care?

You can receive palliative care at any time during your illness, from the time you are diagnosed through the treatment of your disease. Palliative care can be provided while you are receiving medical treatments such as chemotherapy, radiation therapy, bronchodilators (inhalers), oxygen therapy, or intensive care. You do not need to be in a hospital to receive palliative care. This care can be provided in many different settings, such as a clinic, nursing home, hospital, or at your home.

Could I benefit from palliative care?

Persons of any age, from children to the elderly, may benefit from palliative care. If a serious illness negatively affects you and your quality of life, you may receive palliative care. You may already be receiving palliative treatments. Some examples are:

 Condition Medical Treatment Palliative Care
Lung cancer Chemotherapy or radiation therapy Medication to treat side effects of your medical treatments. Side effects managed by palliative care might include fatigue, nausea, poor appetite, pain, or difficulty breathing.
Chronic lung disease, such as Chronic Obstructive Pulmonary Disease (COPD) or Idiopathic Pulmonary Fibrosis (IPF) Oxygen and bronchodilators (inhalers) Medicines and counseling to help with anxiety and difficulty breathing. A fan blowing cool air to reduce shortness of breath.
Severe pneumonia Antibiotics and care in an intensive care unit (ICU) Medications to reduce pain, help with sleep, or reduce feelings of anxiety.

Palliative care may help if you are feeling sad or anxious about your disease, the side effects of your medical treatment, or the effects your illness is having on your family. Palliative care can also help address your spiritual needs.

Who provides palliative care?

Your health care provider may be able to provide palliative care or may refer you to a team of palliative care specialists. Your health care provider and your palliative care specialists make up your palliative care team. Palliative care specialists may be physicians, nurse practitioners, nurses, social workers, chaplains, or counselors. For children, a child life specialist can also be an important member of the team. If you are receiving care at home, providers may be able to make home visits and help coordinate care with other members of your team.

What kind of care is right for me?

In addition to helping you address the symptoms and feelings of stress related to your illness, palliative care providers can help you explore your values, goals, and preferences for medical care. This process is called advance care planning. The palliative care team can work with you to address important questions, such as: “What are my hopes for the future?” or “What do I value most in my life?” Answering these questions can help you with decision-making throughout your illness. The palliative care team can also help you document your preferences for care in the form of advance directives, such as a durable power of attorney for health care or a living will.

How can palliative care help if I am at the end of my life?

Palliative care also includes care at the end of life. Similar to palliative care that can be provided throughout a serious illness, palliative care provided at the end of life focuses on improving your quality of life by managing feelings of physical, psychological, and spiritual distress. This type of care is also called end-of-life care. People who are critically ill may receive end-of-life care in an ICU. Some people receive end-of-life care from hospice providers. Hospice care focuses on comfort and relief from suffering when medical treatments used to prolong life are no longer helpful. Hospice care is generally for people who have months to live and can be provided in a home, nursing home, or hospital. After a person has died, palliative care providers can also provide bereavement care to support the family during the grieving process.

What to Do

  • If you have a serious illness that affects your quality of life, you should ask your health care provider about the role of palliative care in your treatment plan.
  • Ask your health care provider how palliative care could help improve your quality of life.
  • Discuss palliative care with your family members, who may also benefit from the services provided by a palliative care team.

Additional Resources:

Get Palliative Care

Palliative Doctors

The Conversation Project

American Thoracic Society

 

Reviewed Feb.2024 by Dr. Ann Jennerich
Am J Respir Crit Care Med Vol. 197, P17-P18, 2018ATS Patient Education Series © 2018 American Thoracic Society www.thoracic.org

Authors: Ann Jennerich MD, MS, ATSF; Bonnie Fahy RN, MN; and Suzanne Lareau RN, MS
Reviewers: Kathleen Akgun MD, MS, Erin DeMartino MD, Kath Lindell PhD, RN, Constantine Manthous MD, Andrej Michalsen MD, MPH, and Marianna Sockrider MD, DrPH
Illustration credit: OurDesigns, Inc

This information is a public service of the American Thoracic Society.  The content is for educational purposes only. It should not be used as a substitute for the medical advice of one’s health care provider.