Timing is everything: when to consult palliative care

Consults promote additional perspectives and help with complex patient management. As the population ages and healthcare demands increase, providers are consulting palliative care (PC). Nurse practitioners (NPs) should understand when to consult PC.

Information was obtained from an extensive search of the scientific literature to include Pallimed (http://www.pallimed.org/) and the author's clinical experience.

Based on the 2009 Clinical Practice Guidelines for Quality PC developed from the Hospice and PC Coalition, PC should be consulted at diagnosis. These findings have also been validated in a landmark randomized controlled trial by Temel et al. (2010). The goals of PC are to alleviate suffering and promote quality of life for people with illnesses. PC accepts and incorporates hospice philosophies, but is distinct.

Many professional organizations are incorporating PC into their specialties and guidelines. In addition to incorporating PC at diagnosis, PC access needs to be improved. New and experienced NPs may appreciate collaborating with PC specialists. Such conversations and relationships will likely offer practical and supportive guidance to both patients and NPs. Overall, the future for PC is promising.