Dr. Denis Grillo, Ear, Nose & Throat, 02/26/13

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Palliative care defined

By Dr. Denis Grillo

Most of my articles center around problems with the ear, nose and throat system. Occasionally, I come across some reading material that may not be necessarily ENT-related, but I think would benefit my readers and patients.

Recently, there have been some cases in the news highlighting care of sick or elderly individuals and some lines as to what, exactly, is the proper way of taking care of these individuals long term.

There is always an individual decision made by family members, but understanding the distinct differences of types of care available will help.

The word “palliative” means “to tend or serve to one,” and is distinctly different from terminal care. Terminal care predisposes and suggests an endpoint to the process, and puts an estimate on how long someone may live. Terminal care sometimes can suggest benign neglect, where palliative care is preferred because it is an active and total care of patients whose disease process has progressed beyond the point of care or regression.

The goal of doctors is to extend one’s life. But the quality of life must be taken into account, as well.

The goal of palliative care is to achieve the best of both worlds, so to speak, to relieve a patient’s suffering and control of their symptoms until the time of death, and try to restore and maintain one’s functional capacity as long as possible.

I really don’t think there is a situation where doctors can say there is nothing more that can be done. There cam always be something done to maintain quality of life, no matter how short it may be. If cure is not possible, then the goal should be relief of suffering and control of symptoms.

Sometimes there are some barriers to providing good-quality palliative care on the part of the doctor and the patients. Sometimes there is a rational fear of using narcotic pain medications as being dangerous or illegal at the cost of making the patient addicted.

Fortunately, there have been some changes in people’s attitudes that have made this less of a problem, but it still exists to a certain degree.

Providing compassionate care and allowing patients to be comfortable using current medications and technology can be just as cutting-edge to a greatly ill patient as is some state-of-the-art technology such as the computers and lasers nowadays used routinely in surgery. Fortunately, nowadays health care systems have a multi-disciplinary approach to palliative care.

Your doctor or surgeon might be a wonderful doctor, but might need the help of other specialists, hospital staff and services to treat the complexities of pain and symptom management.

In this day and age, there is no lack of effective available tools, but sometimes failure to utilize them properly due to barriers and phobias on the part of the patient and doctor.

Patients who are gravely ill and very much in fear at this point in their lives need not fear the abandonment of their physician, family and friends. As mentioned previously, there is always something, however little, that can be done to help patients.

I would like to thank The American Academy of Otolaryngology and Head and Neck Surgery for their resources in putting together this article.

Denis Grillo, D.O., FOCOO, is an ear, nose and throat specialist in Crystal River. Call him at 352-795-0011 or visit