Palliative medicine: Living well with serious illness

Dr. Kathryn Giorgini

LEWISBURG — With advancements in medicine and the aging of our population, more people are living longer with chronic illnesses. Living longer does not necessarily translate to living well. Most patients who have serious chronic illness such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), dementia, or cancer, have burdensome symptoms they deal with on a daily basis. They may be experiencing pain, shortness of breath, anxiety, or all of these. Patients can struggle to cope with their illness, and often times feel as though they are burdening their family and friends with their disease.

A palliative medicine specialist can help individuals who are experiencing these challenges. Palliative medicine is the care of seriously ill individuals, who have life-threatening and life-limiting disease. It is the goal of palliative medicine to assist with aggressive symptom management. This can be done through medications as well as alternative means (psychotherapy, physiotherapy, acupuncture) that aim to control burdensome symptoms and enhance quality of life.

Another focus of palliative medicine is to have important conversations with the patient and their support system to determine “What matters to you?” NOT “What is the matter with you?” A patient and family’s goals of medical treatment are the foundation of care so that priorities can be set and achieved. Both symptom management and establishment of goals are intended to support the patient and their loved ones through chronic illness.

Finally, palliative medicine can aid in helping families develop good advanced care planning. It is crucial to have conversations about a patient’s end of life wishes during a time in their illness where they are doing well instead of when they are in crisis. Patient and families do better when these discussions are had on multiple occasions and all are in agreement with the advanced care plan. Those patients tend to have fewer hospital stays, less aggressive care toward the end of their life, and earlier admission into hospice care when appropriate.

Being referred early to palliative medicine for chronic disease can hugely impact a patient’s overall care and quality of life. Palliative medicine is an enhancement to the care provided by specialists and primary care physicians. When everyone can work together to care for the whole patient, all aspects of well-being can be improved. It is the goal of palliative medicine to not only support and treat those who are dying, but also to help the seriously ill live as well as they can for as long as they can.

Kathryn Giorgini, DO, is a hospitalist and medical director of Palliative Medicine at Evangelical Community Hospital. To learn more about palliative medicine, call Palliative Medicine of Evangelical at 570-524-6766.




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