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Ambulatory Palliative Care

  • John D. Halporn
  • Simone P. Rinaldi
  • Vicki A. Jackson
Chapter

Abstract

Ambulatory palliative care for cancer patients is the practice of promoting quality of life over the course of this serious illness. Quality of life starts with expert symptom management, allowing patients to have reductions in their pain, constipation, nausea, anorexia, dyspnea, anxiety, and fatigue, among others. Once symptoms are well managed, patients have the opportunity to focus on understanding their disease, a process of cultivating prognostic awareness with the palliative care provider over the course of several visits. Promoting adaptive coping is a parallel process in ambulatory palliative care to provide the patient with tools and skills to manage the unpredictability of their lives, their reduced physical and mental capacities, and the uncertain future. Communication skills and techniques are essential in addressing these palliative care tasks, and important themes of listening, deepening the conversation, and managing strong emotion have established and successful approaches that can be learned by all cancer providers. This chapter presents an introduction to ambulatory palliative care, describing important specifics of common symptom management as well as evidence supporting the aims of palliative care and some of the essential communication skills to accomplish this practice.

Keywords

Adaptive coping Ambulatory palliative care Anorexia Ask-Tell-Ask Best case - Worst case Communication Constipation End-of-Life Equianalgesic Fatigue Goals of care Nausea NURSE method Opioid Palliative Pain Prognostic understanding REMAP technique 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • John D. Halporn
    • 1
    • 2
  • Simone P. Rinaldi
    • 2
    • 3
  • Vicki A. Jackson
    • 2
    • 3
  1. 1.DFCI – POPCAdult Palliative Care Clinic, Dana-Farber Cancer Institute, Harvard Medical SchoolBostonUSA
  2. 2.Harvard Medical School Center for Palliative Care, Harvard Medical SchoolBostonUSA
  3. 3.Division of Palliative Care and Geriatrics, Department of MedicineMassachusetts General HospitalBostonUSA

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