"I explain to patients and families that this specialty is focused on taking care of people who have a serious illness at any point in their life," she says.
"Some individuals are facing a brand-new diagnosis, others have been on treatment for some time, while other folks might be nearing the end of life."
Palliative care means maximizing a patient's quality of life through symptom control, or developing a plan of care consistent with a patient's values, also referred to as goals of care. Palliative care can also be considered in discharge planning for patients receiving hospice services.
2. Palliative care often occurs too late, if at all.
There is no universal, standardized screening for problems such as poorly controlled pain, repeat hospitalizations, or caregiver exhaustion that could trigger an evaluation for palliative care. Therefore, patients usually get this type of help (when it's available) later in the care trajectory than necessary.
"Right now, access to palliative care depends almost entirely on your treating physician thinking about making the referral," says Diane Meier, MD, FACP, a professor of geriatrics and palliative medicine at the School of Medicine at Mount Sinai in New York, NY.
"If your treating physician doesn't do that, you almost certainly will not access the care," says Meier, who is also director of the Center to Advance Palliative Care, which provides tools and training in palliative care.
Another barrier to palliative care is the discomfort it elicits among clinicians not trained in the field, notes Karlekar.
"We're trying to create a culture change in which everyone understands that a goals-oriented conversation is important, and that these conversations happen throughout the disease trajectory, not just at the end of life. In this manner, treatment plans should better align with an individual's goals."
Debra Shute is the Senior Physicians Editor for HealthLeaders Media.