Supportive & Palliative Care

If you or a loved one has a serious illness, the pain and worry can be overwhelming. Our award-winning Supportive & Palliative Care team addresses both the physical symptoms and the stress and worry that accompany a serious illness for both the patients and their families and loved ones.

Many adults and children living with diseases such as cancer, heart disease, lung disease, kidney failure and dementia, experience physical symptoms and emotional distress. Palliative care is not just for patients who have a terminal diagnosis.  Consider palliative care if you or your loved one:

• Suffers from pain or other symptoms due to any serious illness.
• Experiences physical or emotional pain that is not under control.
• Needs help understanding your situation and coordinating your care.

Conditions palliative care can help alleviate:

• Constipation
• Fatigue
• Loss of appetite
• Nausea
• Pain
• Problems with sleep
• Shortness of breath
• Many other symptoms

Palliative care can also help you deal with the side effects of the medical treatments you’re receiving. The goal is to improve your overall quality of life. Our services include:

• Symptom management: expertise in treating pain, fatigue, constipation, breathing difficulties, nausea, loss of appetite, anxiety and depression. Ultimate goal is to prevent and ease suffering and improve your quality of life.
• Advanced care planning:  guidance with difficult treatment decisions, help with navigating the health care system, assistance with Advanced Directives.
• Strong physical, emotional and spiritual support throughout all stages of illness
• Supportive counseling: clear and compassionate communication with doctors and family members. Nurse navigators, chaplains and social workers assistance­ with coordination of care with community services.

Team approach

A team approach is central to palliative care. Your team may include doctors, nurse practitioners and nurse coordinators who specialize in palliative care, social workers, chaplains, nutritionists, counselors and others. Your team spends as much time as you and your family need to help everyone understand treatment options and goals. 

Our team can meet with you during your hospital stay, in the Mass General Cancer Center at Wentworth-Douglass Hospital, or in our outpatient clinic (at Wentworth-Douglass). We also offer virtual visits. 

Ask your health care provider about a referral for Supportive & Palliative Care services, or call us at 603-740-3330 for more information.

Video

Palliative Care: The Extra Layer of Support

American Lung Association video explains the benefits of palliative care.

Play Video Play Video

Our Providers

Elizabeth Dougherty, MD
Sarah MacDuffie, DO
Agata Marszalek, MD
Katie Redpath, APRN
 

Frequently Asked Questions

What is palliative care?

Palliative care is comprehensive treatment of the discomfort, symptoms and stress of serious illness. It does not replace your primary treatment; palliative care works together with the primary treatment you’re receiving. The goal is to prevent and ease suffering and improve your quality of life.

If you need palliative care, does that mean you’re dying?

The purpose of palliative care is to address distressing symptoms such as pain, breathing difficulties or nausea, among others. Receiving palliative care does not necessarily mean you’re dying. Palliative care gives you a chance to live your life more comfortably. Palliative care provides relief from distressing symptoms including pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, problems with sleep and many other symptoms. It can also help you deal with the side effects of the medical treatments you’re receiving. Perhaps, most important, palliative care can help improve your quality of life.

Is Supportive & Palliative care different from hospice care?

Supportive & Palliative care is available to you at any time during your illness. Remember that you can receive palliative care at the same time you receive treatments that are meant to cure your illness. Its availability does not depend upon whether or not your condition can be cured. The goal is to make you as comfortable as possible and improve your quality of life.

You don’t have to be in hospice or at the end of life to receive palliative care. People in hospice always receive palliative care, but hospice focuses on a person’s final months of life. To qualify for some hospice programs, patients must no longer be receiving treatments to cure their illness. Palliative care also provides support for you and your family and can improve communication between you and your health care providers.

How do you know if you need palliative care?

Many adults and children living with illnesses such as cancer, heart disease, lung disease, kidney failure, dementia, among others, experience physical symptoms and emotional distress related to their diseases. Sometimes these symptoms are related to the medical treatments they are receiving.

When should you start receiving palliative care?

It’s never too early to start palliative care. In fact, palliative care occurs at the same time as all other treatments for your illness and does not depend upon the course of your disease. There is no reason to wait. Serious illnesses and their treatments can cause exhaustion, anxiety and depression. Palliative care team understands that pain and other symptoms affect your quality of life and can leave you lacking the energy or motivation to pursue the things you enjoy. They also know that the stress of what you’re going through can have a big impact on your family. And they can assist you and your loved ones as you cope with the difficult experience

Will I have to give up my primary doctor?

Patients who are considering palliative care often wonder how it will affect their relationships with their primary doctors. Will I offend my doctor if I ask questions? Most important, you do not give up your own doctor in order to get palliative care. The palliative care team works with your doctor. Most doctors appreciate the extra time and information the palliative care team provides to their patients. Let your doctor know if you think palliative care could help you. You may also wish to contact your palliative care team. They can help you explain why you would like to receive palliative care.

How do you get palliative care?

The process begins when your doctor refers you to the supportive and palliative care team. You can also ask your doctor for a referral. Our supportive and palliative care team can see you while in the hospital, at the Mass General Cancer Center at Wentworth-Douglass Hospital or in our Clinic located in the hospital by south entrance.

Does insurance pay for palliative care?

Most insurance plans cover all or part of the palliative care treatment you receive, just as they would other services. Medicare and Medicaid also typically cover palliative care. If you have concerns about the cost of palliative care treatment, a social worker from the supportive and palliative care team can help you.

What happens when you leave the hospital?

When you leave the hospital, your supportive & palliative care team will help you make a successful move to your home or other health care setting. We can follow up with you and your loved ones at our outpatient Clinic located at the hospital or in the Mass General Cancer Center at Wentworth-Douglass Hospital.

If morphine is prescribed, will it be dangerous?

If you have an illness causing you pain that is not relieved by drugs such as acetaminophen or ibuprofen, the palliative care team may recommend trying stronger medicines such as morphine. Simply stated, morphine is an opiate – a strong medicine for treating pain. Like other similar opiate medicines (hydrocodone, oxycodone), it provides safe and effective pain treatment. In fact, almost all pain can be relieved with morphine and similar strong drugs that are available today. So no one should suffer because they or their doctor have concerns about morphine or other drugs in the opiate family.

If I take morphine, will I become addicted?

In fact, very few people who use opiates for pain relief ever become addicted or dependent on these medicines. However, it is important to be aware that anyone taking opiates for more than two weeks should not stop doing so abruptly. You should ask your doctor about gradually reducing your dose so that your body is able to adjust. There is no reason to wait until your pain is unbearable before you begin taking morphine. As your pain increases, your morphine dose can be safely increased to provide the relief you need over time. All opiates can cause nausea, drowsiness and constipation. However, as your body adjusts to the medicine, side effects will generally decrease. Also, side effects such as constipation can easily be managed.

As always, if you have concerns about taking these or any medications, talk to your palliative care team. They can tell you about how various medications work, what their side effects are and how to get the most effective pain relief.

Trusted Resources

• National POLST Website
• Provider orders for Life Sustaining Treatment Brochure (PDF)
• POLST in New Hampshire (Video) 
• POLST Maine brochure (PDF)
• Advance Care Planning (Video)