What is Comfort Care at the End of Life?
News articles this week reported that former First Lady Barbara Bush was receiving “comfort care” as she neared the end of her life. The term may not be familiar, so Dr. Toby Campbell, chief of the UW Health Palliative Care program, explains.
What is comfort care?
Comfort care is a euphemism, a term very commonly used between clinicians and between clinicians and families to mean end-of-life care. When doctors are talking to patients about transitioning away from life-prolonging or curative therapies, they often discuss the alternative as comfort-focused therapies, thus the term “comfort care.”
Does comfort care mean no medical therapy?
Comfort care still involves medical therapy, and sometimes lots of medical therapy, but the goals of the therapy are different. Comfort care often implies that the person is reducing the intensity of medical care because the burden is outweighing the benefits and it also commonly means the individual recognizes that they are nearing the end of their life and no longer trying to forestall death.
When is it time to switch to comfort care?
One way to think about it is to imagine where and how someone is spending their time and energy. Someone with heart failure may regularly spend time taking medications, taking their vital signs, having their blood drawn for testing, taking other tests, and visiting their doctor. Someone focusing on comfort care will spend the majority of their time at home with friends and family. They may call the important people home and take the opportunity to say goodbye without a lot of medical-related distraction. They may trade some time for increased control over how and where they spend that time. At home, comfort care is often provided together with the support of a hospice agency. In the hospital, it may be provided by the medical doctors and sometimes with the support of a palliative care team.
Susan Lampert Smith
Date Published: 04/17/2018