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The Palliative Care Trio: Symptom Management, Psychosocial Support and Spiritual Care

palliative care trio

Palliative care is a holistic approach that aims to improve the quality of life for individuals facing serious illnesses. It combines symptom management, psychosocial support and spiritual care to provide comprehensive and compassionate care that seeks to alleviate suffering, promote comfort and foster a sense of peace and dignity throughout the healthcare journey.

“As the medical team is providing this care, they specifically need to understand the relationship between symptom management, psychosocial support and spiritual care,” said Ryan Klaustermeier, MSN, RN, Vice President of Professional Services at Axxess. “We need to make sure that every one of those elements is being assessed and treated so that an individual’s journey through a serious illness is the best and most empowering that it can be.”

Symptom Management

One of the primary goals of palliative care is to alleviate physical symptoms associated with serious illnesses, such as pain and nausea. To treat a patient’s physical symptoms, palliative care providers need to understand the aspects of the patient’s life that are contributing to those symptoms, Klaustermeier says, and develop a treatment plan that best accommodates their needs in the context of their life.

“The nature of pain is holistic and there’s an interplay of psychosocial well-being, spirituality and culture,” said Klaustermeier. “If you’re going to effectively treat pain, you have to be treating every aspect that could be impacting it.”

Klaustermeier outlines the following critical elements of symptom management:

  • Patient and family education: The patient and family need to be educated on the patient’s illness and symptoms, as well as the interventions put in place to mitigate those symptoms.
  • Appropriate referral coordination: Symptoms that require specialized care should be addressed through referral coordination.
  • Patient advocacy: Palliative care providers should advocate for what the patient wants. If a specialist’s recommendation for treatment conflicts with the patient’s goals, the palliative care team should step in and advocate for the patient’s and family’s wishes.

Psychosocial Support

Serious illnesses can harm the psychological and social aspects of patients’ lives, and when psychosocial needs aren’t met, symptoms worsen. Palliative care addresses patients’ psychosocial needs by providing emotional support, counseling and supportive care planning, connecting patients to community resources and specialized psychological treatment when appropriate.

“Consider the social consequences of a serious illness, like being uninsured or underinsured, or maybe an individual is undocumented or experiencing homelessness,” said Klaustermeier. “Explore things we forget to talk about or are maybe a little more risqué to talk about, like intimacy and sex, and make sure people aren’t isolated. These things are all part of a chronic illness.”

Klaustermeier highlights the need for coordinating specialist referrals when a patient’s psychosocial needs surpass the scope of the palliative care team’s skills.

“Another piece of palliative care is recognizing what you can do and what you can’t do, and staying in the appropriate lane,” Klaustermeier said. “That sometimes means referring out to particular specialists. But at the bare minimum, palliative care providers need to be able to recognize and treat common psychological issues like anxiety, depression, hopelessness, substance abuse disorders and withdrawal symptoms, but also be prepared to encounter complex psychiatric issues such as suicidal ideation or persistent mental illness.”

Spiritual Care

Spiritual care is an integral part of palliative care, as individuals facing serious illnesses often grapple with existential questions and spiritual distress. Palliative care teams work with patients to explore their spiritual beliefs, values and sources of meaning. This may involve providing spiritual counseling, facilitating religious rituals or connecting patients with chaplains or spiritual leaders.

“Palliative care teams need to serve each patient and family in a manner that’s respectful to their spiritual beliefs or lack thereof, and also be supportive of them not wanting to discuss or address those things,” said Klaustermeier. “When we’re assessing those needs, we’re asking questions about their spiritual background, their preferences, their beliefs, their values, their rituals, and not just as a patient but as a family. What are their spiritual strengths? What are their current spiritual resources? What existential concerns might they have? Are there questions about their existence, their meaning, their suffering?”

Klaustermeier says to explore patients’ hopes, values and fears.

“All of those things pull into treating the spiritual aspects of someone,” said Klaustermeier. “And again, those then impact the social aspects which then impact the physical aspects, so they’re all interconnected and that’s why it’s so important when we think of palliative care that we’re thinking of that triad and aiming to deliver whole-person care.”

Axxess Palliative Care, a cloud-based palliative care software, was built for flexibility with streamlined workflows from intake to claim submission.


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