Posted by When my mother was diagnosed with advanced heart failure, I assumed the goal was to fight. More medications, more specialists, more monitoring. Every intervention we could throw at her disease. She was exhausted, but I kept pushing. That’s what love looked like to me. Then a nurse used a word I’d never heard before. “Have you considered palliative care?” I bristled. Palliative sounded like giving up. Like hospice. Like admitting defeat.
The nurse sat with me and explained the difference. Hospice is for the end of life, when curative treatment has stopped. Palliative care is for any stage of serious illness. It doesn’t replace treatment. It runs alongside it, focusing on symptom management, quality of life, and emotional support. You can receive palliative care while still pursuing aggressive treatment.
My mother could continue to see her cardiologist. She could keep taking her heart medications. But she could also have someone dedicated to managing her pain, her shortness of breath, her anxiety, her exhaustion. Someone who asked not “How can we make her heart stronger?” but “How can we make her feel better today?” That shift in focus changed everything.
The first thing the palliative care team did was listen. Really listen. They asked my mother what mattered to her. She said she wanted to be able to sit in her garden, to talk on the phone with her sister, to eat meals without feeling nauseous. She didn’t care about her ejection fraction or her blood pressure numbers. She cared about her life.
The team took that seriously. They adjusted her medications to reduce side effects. They scheduled her diuretics earlier in the day, so she wasn’t up all night using the bathroom. They prescribed something for the nausea that had been stealing her appetite. They brought in a physical therapist who helped her conserve energy so she could still walk to the garden. None of these interventions was dramatic. None of them cured her heart failure. But they made her life better. That was the point.
Pain management was the most visible improvement. My mother had been living with chronic pain, but she hadn’t complained. She didn’t want to be a bother. The palliative care team assessed her pain regularly, using simple scales that didn’t require her to explain or justify. They found a medication regimen that kept her comfortable without sedating her. She started sleeping better. She started smiling again. For the first time in months, she asked me to read her a book.
Breathlessness was another symptom they tackled. My mother’s heart failure caused fluid to build up in her lungs, leaving her constantly short of breath. The team taught her positioning techniques that made breathing easier. They adjusted her oxygen settings. They gave her a small handheld fan; the air movement across her face, they explained, could reduce the sensation of breathlessness. It worked better than any medication.
The emotional support was unexpected. A social worker from the palliative care team visited weekly, not to check boxes but to really talk. My mother was scared. She was grieving the life she’d lost. No one had given her space to say that out loud. The social worker just sat with her, listened, and validated. She didn’t try to fix or minimize. She bore witness.
That support extended to me, too. The social worker asked how I was doing, really doing. She connected me with a caregiver support group. She normalized the guilt, the exhaustion, the complicated grief of watching a parent decline. I hadn’t realized how alone I’d been until someone showed up to sit beside me.
The palliative care team also helped with advanced care planning. They facilitated conversations I’d been avoiding, what my mother wanted if her heart stopped, if she couldn’t eat, if she couldn’t communicate. These were hard conversations, but having a skilled professional guide them made them possible. My mother’s wishes were documented, respected, and honored.
When her condition worsened, the palliative care team didn’t abandon us. They increased their support. They managed her symptoms aggressively. They helped me understand what was happening and what to expect. They didn’t push aggressive treatments that would have prolonged her suffering, and they didn’t push hospice before she was ready. They met us exactly where we were.
My mother died in her bed, in her room, with me holding her hand. Her pain was controlled. Her breathing was peaceful. She wasn’t afraid. The palliative care team had helped us create a death that honored her life.
If you have a loved one in a nursing home with a serious illness, ask about palliative care. It’s not just for cancer patients, though it’s excellent for them. It’s for anyone with a chronic, progressive, or life-limiting condition. Heart disease, lung disease, kidney disease, dementia, Parkinson’s, ALS, and palliative care help with all of them. You don’t have to wait until the end. Palliative care is appropriate at any stage of serious illness, even alongside curative treatment. The earlier you start, the more benefit you receive.
Ask the nursing home what palliative care services they offer. Do they have a dedicated team? Do they coordinate with outside palliative care providers? How do they manage pain and other symptoms? What emotional and spiritual support is available? If the answers are inadequate, advocate for change. Palliative care isn’t a luxury. It’s a standard of care that every seriously ill person deserves.
My mother’s final months weren’t easy. She was still sick, still declining, still dying. But she was comfortable. She was at peace. She had good days, real days, not just hours. She sat in her garden. She talked to her sister. She ate meals without nausea. She held my hand. That’s what palliative care gave us. Not enough time. More life in the time she had.
There’s so much more to learn about palliative care and other supportive services in nursing homes. Our website is filled with articles on symptom management, advanced care planning, and advocating for quality care. Head over and explore, because everyone deserves to be comfortable, even when they can’t be cured.
References
Temkin-Greener, H., & Mukamel, D. B. (2020). A systematic review of nursing home palliative care interventions. *PLOS ONE, 15*(1), e0227849. https://doi.org/10.1371/journal.pone.0227849
Miller, S. C., Dahal, R., Lima, J. C., Gifford, A., & Christian, T. J. (2021). High-quality nursing home and palliative care: Challenges and opportunities. *Journal of Palliative Medicine, 24*(S1), S-27–S-32. https://doi.org/10.1089/jpm.2021.0003
World Health Organization. (2020, August 5). *Palliative care*. https://www.who.int/news-room/fact-sheets/detail/palliative-care
Froggatt, K., & Palliative and end of life care in care homes research group. (2021). Palliative care in the nursing home. In *Geriatric medicine* (Oxford Academic). https://doi.org/10.1093/med/9780198831282.003.0005
National Institute on Aging. (2021, May 13). *What are palliative care and hospice care?* https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care