Palliative care is less widely known than most healthcare services that your clients may need. Are your caregivers trained to identify those needs?
Did you know that only 14% of people who need palliative care are receiving it, according to the World Health Organization? This lack of awareness and education is an opportunity for your home care agency to learn from the principles of palliative care and apply them to improve client care.
When I worked as a scheduling coordinator, our marketer invited a local home health liaison to our office to talk about their services. They offered the typical skilled services that you see in home health agencies, but they had another set of offerings: disease management programs.
I noticed that they had a pre-hospice (palliative care) program. One of our clients who had been living with excruciating and untreatable pain came to mind.
I had his son on the phone as soon as our meeting ended and told him about this offering. The client ended up qualifying for hospice – but his son was immensely appreciative of these efforts. He left us a five-star review shortly after.
Having these types of conversations is important for the success of your home care agency. Palliative care can be one of those topics.
Why should palliative care be a point of focus for your home care agency? A variety of reasons including:
Most people don’t know about palliative care
Health professionals are not always trained in palliative care
Foundations of palliative care will help you provide stronger support to your current clients
Let’s dive into what palliative care is and how you can use it in your agency.
Most people don’t know about palliative care.
Palliative care is a multidisciplinary philosophy of caring for patients. It’s focused on improving the quality of life and comfort for patients who are living with serious conditions.
Let’s use pregnancy as an example. While typical clinical teams involve a nurse and doctor, some expectant mothers may elect to use birthing doulas too. These team members act as patient advocates: supporting the mother through breathing exercises and making the experience as easy and painless as possible through holistic means.
Palliative care teams are similar to birthing doulas in the way that they care for patients in a comforting way as opposed to curative means.
According to research done by the Journal of Pain and Symptom Management, 71% of respondents did not know what palliative care was or what it did.
As a home care agency, you have first-hand knowledge about the senior care spectrum and the healthcare system at large that your clients may have no clue about.
To put this in perspective: in 2010, the New England Journal of Medicine did a study on lung cancer patients who used palliative care. Patients reported a higher quality of life and survived an average of 2+ months longer than their peers who did not get palliative care treatment.
Knowing the impact of palliative care, you can teach your caregivers about its principles. Have them share their knowledge with clients.
Healthcare professionals aren’t trained in palliative care.
There is a big deficit in the education and practice of palliative care. According to the Scientific American, “Only 6,500 physicians are board-certified in hospice and palliative care…[t]hat number is between 6,000 and 18,000 fewer physicians than we need, according to a 2010 estimate.”
This knowledge gap extends beyond the classroom. Many patients haven’t had end-of-life conversations with their doctors or their families; responsible parties may not know if their loved one would favor length or quality of life.
As they say, knowledge is power. There are certain healthcare companies that offer palliative care like home health and hospice companies; your home care agency can stand out by knowing the power of palliative care and having meaningful referral partner connections with those providers.
Palliative care is different from hospice care, in that it’s offered at any stage of the disease. Instead of worrying about eligibility requisites such as a six-month prognosis, you can consider palliative care as an option for clients with a variety of serious conditions. Some of them include:
These are only a few of the many conditions that palliative care services can help with.
Palliative care also provides support for symptoms, including:
Anxiety and depressive disorders
Fatigue and extreme exhaustion
Your clients may be living with these symptoms without expressing any concerns, and your caregivers can be their advocates. Palliative care might be a viable solution to manage their symptoms.
Not every condition is treatable – but hands are meant to be held and symptoms can be managed. The comfort care approach used in palliative care includes education on how to have tough conversations about death and advance directives.
Writer and surgeon Dr. Atul Gawande, in an interview with PBS, said:
“The big difference in the way that palliative care doctors are asking us to have these conversations with patients is to move from the facts and figures, the risks and the benefits to helping people cope with their anxieties about illness and about death.”
These insights are not just for doctors. Your caregivers can be involved in these conversations. They can help your clients feel more at ease and have peace of mind regarding their conditions.
By teaching your caregivers about palliative care and identifying the need in your clients – your staff will be able to strengthen the care you provide.
Palliative care will help you provide stronger support to your current clients.
Comfort care measures are a wonderful addition to any plan of care regardless of a client’s condition. Everyone can use some pain relief or a hand to hold when having an episode of anxiety.
If you have clients that don’t know about palliative care but are experiencing conditions that can be managed by palliative care services, your care team can help solve a need that your clients might not have known about.
If you didn’t know about palliative care, you might feel constrained to either hope that your client can tolerate the symptoms or have them evaluated by a hospice to see if they fit the six-month prognosis, among other admission requirements.
Palliative care provides a middle-ground solution. This halfway point may help your clients become more comfortable talking about their symptoms and their feelings about death, etc.
Since palliative care is multidisciplinary, it can cover a variety of situations and aspects of a client’s life, which include:
Social support: Social workers can help plan and organize family meetings and locate resources that may help their situation.
Emotional support: Counselors and psychologists can help clients process their emotions.
Spiritual support: Whether you have religious or nonreligious clients, they can all speak to a nondenominational palliative care chaplain about their beliefs and ideas about Prayer is helpful in many of these situations.
Symptom support: Many palliative care providers offer condition-specific support like respiratory programs, rehabilitative therapies, pain management programs, and pre-hospice bridge programs.
Palliative care principles can help your agency further its shift into client-centered care as opposed to task-based care.
Your caregivers can lead the initiative by taking inventory of a client’s social, emotional, spiritual, and clinical needs. They can assess what they can and can’t help clients with. Caregivers could also notify your staff to bring additional services in that aren’t within your scope of care.
Palliative care specialty learning path
The nurses who developed our training courses wanted to change the narrative and fill the gap in knowledge about palliative care by creating this learning path for your caregivers.
Your caregivers will learn:
End-of-life care: Caregivers will be exposed to what end-of-life care is, what each team member does, and how they can help clients at the end of life.
Caring for bedbound clients: Some of your clients may be bedbound. Your caregivers will learn how to look out for pressure sores or wounds, and they’ll learn how to reposition patients correctly.
Understanding pain management: Home care clients may be using a lot of prescriptions and may not understand all their options to manage pain. Caregivers will also learn about deprescription and what to look out for if medications are changed.
Oxygen safety for caregivers: Oxygen tanks and portables are some pieces of equipment that help clients breathe. Caregivers will learn how to care for clients who use oxygen, and how to keep their clients safe.
Talking about death: Caregivers will learn how different cultures talk about death, and how to approach these conversations with a client.
Understanding advance directives: Advance directives are important documents that outline what life-saving measures clients want to be taken, and it’s important for caregivers to learn what they do and what is in them.
When a caregiver finishes this series of courses, they will receive a palliative care specialist badge that they can display on their name tag. In addition to promoting and spreading awareness of palliative care, this can also help caregivers assure clients of their commitment and improve the quality of their care.
Keep your clients comfortable.
Dr. Lesley Reece says “Life is meant to be enjoyed. Not endured.” Your clients should enjoy the lives that they lead; your caregivers and office staff have a variety of resources to enable them to enjoy their lives at home.
Every home care agency wants to be the best provider and give the highest quality of care to their clients. By promoting palliative care and educating your team about it, you can put more meaning and proof behind the quality care that you provide.
Palliative care is a great tool that can help your clients age in place while remaining comfortable and pain-free.