For many Arkansans, the first step toward palliative care is simply knowing it's there.
Palliative care exists primarily to help ease suffering during a serious illness. It prevents or treats symptoms of an illness as well as the side effects stemming from medication or other forms of treatment.
It also is designed to treat the emotional, spiritual and practical problems an illness can pose, not just to the patient but also family members, especially those helping to provide care.
"The goal is to improve quality of life," said Dr. Brian Bell, chief medical officer for Arkansas Palliative Care. "That's chiefly accomplished by reducing suffering."
Palliative care grew out of hospice care. Both types provide comfort, but palliative care can begin at diagnosis and take place during life prolonging treatment, while hospice care is provided most often when treatment has ended and it becomes clear that a patient is in the terminal phase of their illness.
Whether it's a terminal or non-terminal case, palliative care treats symptoms and effects like pain, trouble sleeping or breathing and loss of appetite or nausea, among others.
The main palliative care intervention is just spending time with patients and families so they completely understand the benefits and burdens of a treatment and also by helping them navigate the complex medical system.
"Patients who are not terminal still have a lot of needs and they weren't being met," Bell said, explaining the genesis of palliative care.
Bell pointed out that in the past year Arkansas Palliative Care has added four new programs for a total of five. It has added two community-based programs and a second and a third hospital based-programs.
As yet, there are not enough palliative care programs or board-certified palliative and hospice physicians, Bell said.
"The big problem there is getting qualified physicians, plus getting acceptance from the community, including medical providers. This is an important thing we need to offer our state."
Still, improvements and growth have come, and Arkansas Palliative Care, and palliative care at large, are seeing the footprint expand.
"Part of the problem is just raising awareness in the state," Bell said.
To help achieve this goal, the governor has initiated The Palliative Care and Quality of Life Task Force to increase access in Arkansas.
With awareness, Bell said, people can see that palliative care is able to achieve the "triple aim" in medicine: improve outcomes, improve quality of life/patient experience and lower costs by helping to reduce repeat admissions or the number of emergency room trips.
"Palliative care's unique approach allows us to tailor to the patient's wants and needs with the services that achieve their goals of care," Bell said.
Hospice care and most things related to it are covered by the Medicare Hospice Benefit, while palliative care is paid through insurance using the standard, co-payment/deductible model on a visit-by-visit basis.
Also, Bell said, palliative care stresses advanced planning, which can further ease the minds of both patient and family. Dealing with this may include an in-depth discussion of the patient's goals of care and then completing the appropriate documents like a living will or a health care power of attorney.
During an illness, patients and their families often deal with fear, anxiety, feelings of hopelessness and depression, as the situation affects work and everyday life. Under palliative care, counseling, support groups, family meetings and referrals can be arranged or offered.
"We not only focus on the patient in both hospice and palliative care, we actually have put a lot of emphasis on the patient's caregiver and family," Bell said. "The better we can equip and care for them, the result is our patients will get better care."
"Palliative care can be beneficial for anyone experiencing serious illness," Dr. Bell said. "No one needs to suffer unnecessarily."