Comfort Care for End-Of-Life Patients

Comfort care is a form of medical care that focuses on relieving symptoms and optimizing comfort as patients undergo the dying process. When a patient can no longer benefit from curative treatment, comfort care can allow a better quality of life at the end of life.

A man in a hospital bed holding hands with his wife
Brad Wilson / Getty Images 

What Makes Comfort Care Unique

Unlike almost every other form of medical care, comfort care does not seek to cure or aggressively treat illness or disease. Instead, it simply focuses on easing the effects of the symptoms of the disease as patients reach the end of their lives.

Patients do not have to be in a hospital to receive comfort care. Instead, this kind of care can be given at home and nursing facilities in addition to hospitals. Hospice care is one model of comfort care delivery.

Which Patients Receive Comfort Care?

Comfort care is typically administered to patients who have already been hospitalized several times in the process of trying to defeat the illness. When it becomes clear that further medical treatment is unlikely to change matters, comfort care may be administered if the patient chooses. Comfort care is also known as palliative care and is designed for patients who want to focus on the quality of their last days of life rather than on the quantity.

In some cases, switching to comfort care can actually prolong life, while continuing aggressive treatments can shorten it.

Symptoms or Conditions Treated With Comfort Care

Patients with a wide range of health conditions can receive comfort care. This includes cancer patients, heart disease patients, chronic obstructive pulmonary disease patients, and patients with dementia or Alzheimer's disease.

Comfort care for a variety of conditions can also help treat symptoms such as nausea, vomiting, constipation or respiratory difficulties. Patients may be given medication and various forms of therapy to treat these problems as well as anxiety, insomnia, or pain.

Palliative radiation therapy is one form of comfort care. This form of radiation isn't used to cure cancer but to treat the symptoms caused by inoperable tumors. This radiation can shrink tumors and alleviate symptoms such as bleeding, spinal cord compressions or obstructions in the throat.

Barriers to Obtaining Comfort Care

The scarce number of palliative care specialists means that the patients who need comfort care don't always get it. Generalists or specialists in other fields are usually tasked with providing such treatment. This leaves terminal patients vulnerable to suffering needlessly in their last days. The solution to this problem is to train all clinicians in the specifics of end-of-life care.

Comfort care, however, isn't just about tending to a patient's physical needs but to a patient's spiritual needs as well. Comfort care providers must offer emotional support to patients and their family members to address the psychological turmoil commonly experienced during the end-of-life stage. Comfort care or palliative care is usually delivered through a group of multiple disciplines, and not just a physician. Nurses, chaplains, social workers, music therapists and other forms of counselors, all come together to help the patient as well as their entire support system cope with an advancing illness and to decrease the suffering associated with it.

Sometimes loved ones oppose stopping aggressive treatment for a condition and moving to comfort care. They may feel that there is still hope and not realize how much discomfort the treatment is causing their loved one. It can take diplomacy and education to ensure the patient's needs and wishes are honored.

1 Source
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  1. National Institute on Aging. Providing Care and Comfort at the End of Life.

By Angela Morrow, RN
Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.