Neuro-Palliative Care – by Dr. Jocelyn Jiao

NEURO-PALLIATIVE CARE OVERVIEW



Jocelyn Jiao, MD
Stanford Movement Disorders Specialist and Palliative Care Physician

Slides

Video


Editor’s Note:  These are brief notes from Sue Kelly about what she got out of the presentation.


The idea of palliative care can seem scary because of the misconception that it is only hospice care. Palliative care is many things, and is built to answer the question:
what does your best life look like?

Palliative care focuses on the person beyond the disease. It is a holistic approach, involving many care members, including doctors from all disciplines, nurses, social workers, and chaplains. It is caring for the mind, body, and spirit as well as the practical.

Palliative care's goal is to improve your quality of life and help with difficult decisions. Thus, it is appropriate for anyone facing a serious illness. To receive palliative care, it must be ordered by a doctor; generally, insurance will cover it.

Palliative care can be done during any stage of illness: newly diagnosed, pursuing treatment, pursuing clinical trials, or at the end of treatments. In addition, many decisions need to be made for those with a serious illness, such as Advance Health Care Planning, Advanced Directives, POLST forms, and treatment options. The palliative care team can assist with all the needed planning. 

Hospice care is a small part of palliative care. Hospice care is focused on the last few months of life and if treatments bring comfort. Palliative care overall seeks to understand what the patient’s goals are and how they can be achieved. 

Palliative care is based on the needs of the patient, not the prognosis. Does the symptom need medication? Psychological care? An integrative approach? Or spiritual advice? Palliative care considers all options through its interdisciplinary approach.

Palliative care can address these common problems of MSA: pain, difficulty breathing, muscle spasms, increased saliva, irritability, anxiety, and depression.

Palliative care is about waking up your joy and living life as you envision. 


Editor’s Note:  These are more detailed notes, in case you are interested in reading further!  The author is also Sue Kelly.

The idea of palliative care can seem scary because of the misconception that it is only hospice care.  Palliative care is many things, and is built to answer the question: what does your best life look like?

What is palliative care?  How is palliative care different from other parts of medicine?  When and how can someone benefit from palliative care?  How does palliative care help people live their best life?  What is the difference between palliative care and hospice?

Palliative care focuses on the person beyond the disease.  It is a holistic approach involving many care members, including doctors from all disciplines, nurses, social workers, and chaplains.  It is caring for the mind, body, and spirit as well as the practical.

How is palliative care different?  Team members include doctors and nurses who prescribe medication, help with medical decisions, and coordinate with other doctors.  The social worker's focus is on emotional support, caregiver support, medical equipment, and financial concerns.  A chaplain provides spiritual support,  existential distress council, and prayers or blessings.

Palliative care is specialized health care for people living with a serious illness.  It intends to provide relief from the symptoms and stress of the illness.  Common diagnoses palliative care is appropriate for include advanced cancer, heart failure, multiple systems atrophy, atypical Parkinsonian conditions, Parkinson’s disease, and ALS.

Palliative care's goal is to improve your quality of life and help with difficult decisions.  Thus, it is appropriate for anyone facing a serious illness.  To receive palliative care, it must be ordered by a doctor; generally, insurance will cover it.

Palliative care can be done during any stage of illness:  newly diagnosed, pursuing treatment, pursuing clinical trials, or at the end of treatments.  In addition, many decisions need to be made for those with a serious illness, such as Advance Health Care Planning, Advanced Directives, POLST forms, and treatment options.  The palliative care team can assist with all the needed planning.

Hospice care is a small part of palliative care.  Hospice care focuses on the last few months of life and whether treatments bring comfort.  Palliative care overall seeks to understand what the patient’s goals are and how they can be achieved.

Hospice care can be done wherever a patient chooses (home, care facility, hospital).  They can provide all the medical equipment for the ease of the patient and provide on-call nursing.  The interdisciplinary team works together for the patient.

Palliative care is proven to be beneficial.  Median estimates of survival:  11.6 months in the early palliative care group and 8.9 months in the standard group without palliative care.

Palliative care has many benefits.  It leads to improved:

  • Quality of life
  • Symptom control (i.e.pain, shortness of breath)
  • Spiritual well being
  • Psychological symptoms
  • Satisfaction with care
  • Fewer hospitalizations
  • Fewer hospital days
  • Less burden on caregivers

When do I need palliative care?  If you have a serious illness with difficult symptoms, difficult decisions, or difficulty coping, palliative care is appropriate.

Palliative care is based on the needs of the patient, not the prognosis.  Does the symptom need medication?  Psychological care?  An integrative approach?  Or spiritual advice?  Palliative care considers all options through its interdisciplinary approach.

Palliative care can address these common problems of MSA:  pain, difficulty breathing, muscle spasms, increased saliva, irritability, anxiety, depression, coping, stress, fatigue, and low appetite.

Palliative care is about waking up your joy and living life as you envision.

 

Information given during the Question-and-Answer session

Palliative care can be delivered alongside treatments.  At all stages of illness, palliative care can be given. Hospice is focused on comfort care.

Hospice isn’t giving up but living with what gives you joy and meaning. Living to the last moments of life.