Palliative Care

Critically ill ICU patients can benefit from Palliative Care, especially as the ICU days mount up.

Not all patients will recover.

Most will have some good and some bad days. 

It's difficult for the ICU doctors and nurses to predict a final outcome. For families, it's even  harder.

This is your loved one and very precious to all of you. At this time the Palliative Care Team can be a big help to you.

What is Palliative Care?

The Palliative Care team will support your family during this stressful and difficult time. They will answer your questions and help, if asked, with difficult decisions.

They team will help the ICU team with being sure your loved one is comfortable and has appropriate pain control and sedation.

Palliative Care is a specific medical specialty and all members; doctors, nurses, social workers are trained to deal with these kinds of situations.

They are there to help and support you and your family. They are not there to tell you what you must do.

Above, the Palliative Care rounding at the bedside of a critically ill patient.

Palliative Care Does What?

The first thing is to be sure all family members understands your loved one's problems and the overall ICU course to now. Why are they not improving?

If there is no Living Will or Advanced Directive they will work with you to find out  what your loved one would want done.

In a critically ill patient, the decision usually come down to one of three things:

1.Stop aggressive care and keep our loved one comfortable. we will Let nature take its course.

2.Continue all care but;  if the heart stops, no chest compressions or breathing tube. This is called DNR

3.Continue to do everything; full care.

Other Options

If aggressive care will be stopped, the Palliative Care team will ensure your loved one has enough medication to prevent any pain or discomfort.

A DNR order only applies if the heart stops. Otherwise the critical care team will continue with full care.

If Hospice is requested the they can arrange transfer to the facility.

A patient too unstable for transfer can have Hospice either in the ICU or a floor room. Palliative Care will be directly involved the whole time.

If the patient can go to a room outside the ICU, there is more privacy for your loved one and your family. This will vary with each hospital.

Under these circumstances the Palliative Care will be the primary care team for your family member,

If you desire, they can walk everyone  through the steps for organ donation.

Remember  You, your family and the nurses and doctors all want what's best for your loved.

There will probably be many conversations.

Be sure all your questions are answered and do not rush any decisions.

Questions to Ask

• Do we absolutely need to have the Palliative Care team involved?
• Is palliative care only for dying patients?
• How does the Palliative Care Team work with the ICU team?
• Which team is actually in charge?
• Is any of this a form of euthanasia?
• If our loved one is too unstable to go to a hospice facility. what will hospice do in the hospital?
• What if there is no living will?
• What happens if our family cannot agree on what to do?
• When should we get an Ethics consult?
• How does the Ethics consult help?
• If we decide on Comfort Care and let nature take it's course. can we stay in the room with our loved one?
• With Comfort Care, how will be be sure our loved one is not in any pain?