Palliative Care – ComfortCare

Palliative Care – ComfortCare2018-05-25T16:40:14+00:00

What is palliative care?

Palliative care improves the quality of life for patients dealing with serious, chronic or terminal illnesses. It addresses a patient’s psychological, emotional, and spiritual well-being, as well as their physical symptoms.

Palliative care focuses on managing pain and providing relief from related symptoms, including shortness of breath, fatigue, constipation, nausea, loss of appetite or difficulty swallowing or sleeping. It improves the patients’ ability to tolerate medical treatments.

Palliative care is well-suited for patients who want to manage symptoms associated with active treatment for disease (i.e. chemotherapy and radiation) and other effects of chronic illness. This helps patients to maintain their independence and a higher quality of life.

What is the difference between palliative care and hospice care?

Palliative care and hospice care share a major characteristic: care. However, they each are distinct in their delivery.

The goal of palliative care is to manage pain and relieve other symptoms. It can be delivered while a patient pursues life-prolonging or curative treatments and when a patient’s prognosis is greater than six months. Though most closely associated with serious illness at an advanced stage—such as terminal cancer, chronic lung disease or heart failure—-palliative care can also be delivered along with curative treatments.

Palliative care is delivered with an interdisciplinary, collaborative approach by a care team that may include nurses, therapists (speech, physical, occupational), a physician, certified home health aides, a social worker and a dietician. Often, patients view palliative care, which is administered at home, as a “bridge” to hospice care.

The goal of hospice is to prepare the patient and his/her family for death. It is generally appropriate for someone with a terminal illness and a life expectancy of six months or less. The focus of hospice care is to enable patients to experience the end of their lives with dignity and as fully as possible.

What are the benefits of palliative care?

High-quality palliative care can mean the difference between a comfortable existence and one that involves suffering. There is often no need for patients to suffer from shortness of breath, uncontrolled pain, or nausea. Palliative care also can help a patient’s loved ones begin to deal with the issues of grief and bereavement. The social worker often facilitates a conversation between the patient and family members to discuss the seriousness and terminal nature of the patient’s diagnosis.

Involvement of palliative caregivers and coordination of care is not always the norm in treating patients with advanced disease. A complex case may be managed by clinicians in specialties ranging from cardiology to endocrinology and pulmonology. Our skilled clinicians effectively communicate with physicians about their patients’ care and work with a patient’s family to articulate the patient’s needs to the physician so that all parties are well-informed.

Palliative care gives patients a choice about their treatment at a crucial juncture in their lives. They are able to pursue various treatment options that may prolong their lives so they can focus on spending time with family or meeting personal goals. Those electing palliative care have often established long-standing relationships with a visiting nurse service and find it more comfortable to continue working with caregivers they know and trust – especially in a home environment.

Who provides the care?

Working in conjunction with a patient’s primary care physician, the palliative care team can include nurses, rehabilitation therapists, social workers, home health aides, and more. This interdisciplinary team creates and implements a plan of care based not only on a patient’s diagnosis but on the challenges with which he/she may be struggling – from anxiety about the difficulty of caring for young children while ill, to a family caregiver’s stress or depression. The Natick VNA has its own Medical Director who can advise patients’ primary care physicians and clinical staff about medication and treatment options.

What kind of care is provided in this way?

  • Expert management of pain and relief of symptoms
  • Emotional and spiritual support for patients and their families
  • Close, clear communication
  • Guidance with difficult and complex treatment choices
  • Help navigating the healthcare system
  • Help preparing for death
  • Bereavement support

What credentials do palliative care nurses hold?

  • The National Board for Certification of Hospice and Palliative Nurses (NBCHPN®) Certified Hospice & Palliative Nurse (CHPN) certification validates a nurse’s competence and knowledge in the specialized areas of hospice and palliative care. The certification examination for Hospice and Palliative Care Nurses is offered by the American Board of Nursing Specialties.
  • The Natick VNA highly values staff education. In preparation for this program, our palliative care team completed a six-week course on palliative care, pain and symptom management – working toward certification as Hospice and Palliative Care nurses and nursing assistants.
  • Our social work staff has extensive experience in helping patients and their families cope with illness and issues around death and dying. All of our social workers hold CHP-SW certifications, and our aides hold CHPNA certifications.

Other Facts:

  • Palliative medicine officially became a medical subspecialty in 2006 (American Board of Medical Specialties).
  • Approximately 90 million Americans are living with serious and life-threatening illness, and this number is expected to more than double over the next 25 years with the aging of the baby boomers.
  • By 2020, the number of people living with at least one chronic illness will increase to 157 million.
  • Today, seven out of ten Americans die from chronic disease.*
  • Approximately 6,000,000 people in the United States could benefit from palliative care.

“Other Facts” source: Center to Advance Palliative Care
*Source: Centers for Disease Control and Prevention

Read U.S. News & World Report article, What You Need to Know About Palliative Care.

Frequently Asked Questions:

ComfortCare is the Natick VNA’s palliative care program. A team of Natick VNA certified specialists delivers our ComfortCare to patients anywhere they live, with the exception of a skilled or long-term care facility.
Yes, there are three key differences:

  • Our ComfortCare staff are all certified in palliative care.
  • ComfortCare is offered in the patient’s own home.
  • ComfortCare is not affiliated with any hospice or hospital.
The ComfortCare option may be introduced by the patient, by the patient’s family or by the treating physician – usually an internist or oncologist.
Hospice is not appropriate for a patient receiving curative treatment. The goal of ComfortCare is to manage pain and relieve other symptoms so the patient can continue with their prescribed treatment and maintain independence for as long as possible.
Patients receiving ComfortCare keep their existing relationship with their treating medical team and institution.
Yes. The Natick VNA is an independent home health agency. Our patients’ plans of care are directed by their primary care physicians (PCP). The Natick VNA’s Palliative Care Medical Director is available in a consultative capacity when the PCP has questions or concerns regarding pain and/or symptom management.
Yes. One of the goals of ComfortCare is to alleviate the side effects of treatment, so the patient may continue with the prescribed course of treatment. Medical social work, nutrition and personal care are often areas that the Natick VNA is able to address, working with the patient, physician and family.
No. ComfortCare is appropriate to improve the quality of life of patients dealing with serious chronic illness, who are currently receiving or may want to receive treatment. However, patients currently under care of the Natick VNA who wish to maintain the relationship with their caregivers may do so while receiving end-of-life care. If we feel that a patient’s needs are out of our scope of expertise, we will gladly make suggestions for an alternative care provider and facilitate the transfer of care.
For additional information, visit The Joint Commission and review its Speak Up brochure or call the Natick VNA at 508-653-3081 to speak with one of our knowledgeable in-home care experts