November is National Palliative Care Month, designed to bring awareness to a holistic treatment begun in the early 1990s that focuses on improving the quality of life for people with serious illness. Far more than management of physical symptoms, palliative care is a multidisciplinary approach that addresses the psychological, spiritual, and social needs of both patients and their caregivers.
Once primarily associated with cancer victims, palliative care has expanded over the past two decades to include people living with chronic illnesses such as heart or kidney disease, emphysema, dementia, or Parkinson’s disease. The goal is not to replace standard medical treatment but to enhance comfort and improve function.
Palliative care has been shown to minimize unnecessary or expensive interventions. A January 2025 study in the Journal of the American Medical Association found that dementia patients receiving palliative care had a 50% reduction in emergency room visits and hospitalizations. The National Institutes of Health reported similar outcomes for cancer patients receiving palliative care, also noting lower costs and improved satisfaction.
Despite such evidence, access remains low. Experts estimate that only 25% to 40% of the roughly 14 million Americans who could benefit actually receive palliative care, largely because it is confused with hospice — an option reserved for those nearing the end of life who have chosen to forgo curative therapies. Palliative care, by contrast, can begin at diagnosis and run concurrently with active treatments such as chemotherapy, dialysis, or oxygen therapy.
Other accessibility barriers, according to the Center to Advance Palliative Care, include a lack of health insurance and travel distances, especially in rural areas. There are also workforce shortages: Palliative care specialists — doctors certified in hospice and palliative medicine, and nurses and social workers with dedicated training — are in limited supply relative to most other medical fields.
Eligible patients are referred by their primary care professional to an interdisciplinary palliative team made up of health care providers, social workers, nurses, and spiritual advisors. Care teams can be clinic-based, such as Hudson Valley Medical Health Choices (with offices in multiple counties, including Dutchess and Columbia), or hospital-based, like Vassar Brothers Medical Center in Poughkeepsie.
After an intake exam by the team’s medical provider, appropriate team members determine a unique treatment strategy and set future appointments. The family is included in the decision-making (with the patient’s consent), and if needed, trained in caregiving skills.
Palliative therapies can be provided in hospitals, outpatient clinics, at home, or in skilled nursing or assisted living facilities. A team approach helps ensure that the treatment plan aligns closely with the patient’s personal values and treatment preferences, which typically prioritize minimizing discomfort and maximizing functionality. Medicare, most private insurances, and New York Medicaid cover all or part of palliative care treatment.
Palliative clinicians can prescribe medications and often incorporate complementary therapies as part of a whole-person approach to easing discomfort. For instance, nausea may be managed with antiemetics alongside breathing exercises or aromatherapy. A social services navigator acts as the team’s anchor, coordinating care and linking patients and caregivers to vital resources such as financial assistance, transportation, and mobility aids. Counseling is also available — for both patients and their families — to address the depression, anxiety, and fear that often accompany serious illness.
The palliative care team facilitates discussions about advance directives and can help file legal documents that detail patients’ wishes for medical treatment if they become unable to speak for themselves. A living will outlines specific therapeutic preferences, and a health care proxy designates a medical decision-maker. (The National Institute on Aging recommends completing these at any time, even while healthy.) Other health mandates include medical directives for life-sustaining treatment (MOLST), and do not resuscitate (DNR) orders.
The team can also ease the transition to hospice care whenever necessary, helping the patient weigh the benefit of life-prolonging treatments against the risk of debilitating side effects.
For more information on palliative care and eligibility ask your primary provider or visit getpalliativecare.org.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.