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Rural Palliative Care Resource Center - Understand

Using palliative care principles and practices supports seriously ill patients and their families across all settings of care. Rural communities have unique opportunities and challenges while providing patient and family engagement, care coordination, and enhanced communication to enhance the quality of life and holistic care for patients and their families. The following key concepts and resources can assist with gaining a common understanding of palliative care and how to begin a rural community based program.

Key concepts

Palliative care is a newer field for many health care providers. This approach to managing serious and advanced illness centers on relieving suffering and improving quality of life for patients and their families. Palliative care teams help patients and their families understand treatment options, and facilitate effective communication among health care professionals, patients, and family members—bringing together the support systems that patients need to determine how to plan for the best quality of life and care. Palliative care differs from hospice in that it is appropriate at any point in a serious illness and can be provided at the same time as curative treatment.

Palliative care is growing in importance in care delivery. As our state and nation age, as awareness of the benefits of palliative care grows, and as pressure to improve value in health care continues, palliative care will move to a place of greater prominence in the care delivery system.

People in rural communities have less access to palliative care services, but potentially greater need. To date, the majority of palliative care programs have developed primarily in large hospitals in urban settings and delivery models for palliative care for rural communities lag behind. However, rural populations are disproportionately ill, disabled, poor, and older. Rural adults are also more likely than their urban counterparts to have a range of chronic conditions.

Palliative care programs and services align well with other efforts to redesign care delivery. Health reform efforts at the state and national levels are calling for increased coordination across settings of care and increased focus on individuals with multiple chronic illnesses. Development of interdisciplinary palliative care services can be a cornerstone of better addressing the needs of patients with life-limiting illness and high health care costs.

Rural communities are uniquely positioned to meet the challenges of providing palliative care through collaborative efforts. Rural communities with similar areas of focus can benefit from structured opportunities to connect and share tools and lessons learned in implementation. A set process and timeline, access to palliative care program development expertise, and external facilitation to help initiate and develop community-based teams are important aspects that can assist in further developing community-based palliative care efforts in rural areas.

Resources

Center to Advance Palliative Care/CAPC. Tools, resources, and clinical training to assist in developing, strengthening, and expanding palliative care programs. Website has free and for members only sections.

Clinical Practice Guidelines for Quality Palliative Care, 4th edition. These guidelines expand on the eight domains of palliative care and include examples, tools, and resources.

Introduction to Building a Community Palliative Care Program. (39-minute webinar). An overview of the basics of palliative care and creating a program, March 20, 2018. Slides (46-page PDF)

What Are Palliative Care and Hospice Care? This webpage from the National Institute on Aging explains the difference between the two care options.