About Palliative Care

Nancy Joyner Consulting - About Palliative Care

Learn more about Palliative Care

Palliative Care- An Extra Layer of Support. Palliative (pronounced pal-lee-uh-tiv) care is specialized healthcare for people with serious illness. Palliative Care:

  • focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or prognosis.
  • is provided by healthcare professionals who work together with patients and families to provide an ‘extra layer of support’.
  • is appropriate at any age and at any stage in a serious illness.
  • is provided along with curative treatment or can be focused on comfort measures only.

It’s about Comfort, Communication, Choices and Control:

  • Comfort: Easing pain, suffering and other symptoms.
  • Communication: Providing expert information with everyone involved.
  • Choices: Offering options as well as alternatives for patients and families.
  • Control: Honoring and respecting the Patient (and Family) informed decisions.

Go To Inquiry Form

Q: Isn’t palliative care the same as hospice care?
A: No. All of hospice care is palliative care, but not all of palliative care is hospice. Hospice focuses on comfort and specific end of life care whereas palliative care is available and offered to those patients and families facing serious illness. Palliative care can be offered months to years before someone is appropriate for hospice care.

Q: Can I have palliative care when I still want everything possible for me to get better?
A: Yes. Anyone who has a serious illness can benefit from palliative care. You can get care and treatment for your illness as well as receiving palliative care at the same time. You do not have to choose over the other.

Q: Why would I want palliative care?
A. Most doctors and nurses focus mostly on you as a patient with a disease. However, palliative care will focus on you as a person, your family and be a strong advocate to get all of your questions answered. The palliative care team members want to know more about what is important to you and what you and your loved one’s concerns are. Palliative care sees how your illness affects not just you but your family and loved ones.

Q: Is palliative care available where I live?
A. Not all regions or hospitals have palliative care. Nancy will assist you and your healthcare providers to bring palliative care to you the best way we can. She will find what services and providers are available for you. She is an expert in palliative care information and education and will assist you to the best of her ability.

What Is Palliative Care?

Palliative care is specialized medical care for people with serious illnesses. It is appropriate at any age at any stage in a serious illness and can be provided together with curative treatment. Palliative care promotes quality of life by addressing the physical, psychological, emotional, cultural, social, and spiritual needs of patients and families. It offers treatment of pain and other symptoms; relief from worry and distress of illnesses; close communication about goals of care; and well-coordinated care during illness transition. It also provides care across treatment settings and support for family/caregivers and offers a sense of safety in the healthcare system. Palliative care is delivered by a team of physicians, nurses and other specialists who work with the patient’s other doctors to provide an extra layer of support.

What Is Hospice Care?

Hospice care is a team approach to expert medical care for individuals who face a life-limiting illness. With a focus on comfort, the team develops a plan of care tailored to each individual’s needs and goals. It includes pain and symptoms management, personal care, emotional and spiritual support, and grief support for the each individual’s loved ones. All of hospice is palliative care, but not all of palliative care is hospice.
Palliative Care

For more information:
Nancy Joyner, MS, CNS-BC, APRN, ACHPN®
218-779-5037 • njoyner@nancyjoyner.com

Palliative Care Continuum Diagram modified from:
• Lynn, J. 2005. Living Long in Fragile Health: The New Demographics Shape End of Life Care. Hastings Report. November-December 2005, S14-18.
• American Cancer Society/Cancer Action Network. 2016 North Dakota Palliative Care Presentation. Bismarck, ND.
• Center to Advance Palliative Care. 2018. Diane E. Meier, Director

Palliative Care


What is the focus of this type of care?
To maximize the patient’s quality of life
Comfort care, rather than cure, assist with goals of care, plan for end of life cares
What services are provided?
Manage symptoms, discuss goals of care, pros and cons of treatment options, provide extra support and care coordination
Intensive comfort care that relieves pain and symptoms while attending to an individual’s physical, personal, emotional, and spiritual needs
Who qualifies?
Anyone living with a chronic illness or disease; available for anyone at any stage of a serious illness
Patients with a serious life-limiting or terminal illness; supports those with a life expectancy of months, not years
When should we start services?
From the time of diagnosis through treatment and living with the illness
When the patient chooses to stop or go without curative treatments, the focus changes from treating the disease to providing comfort and relieving pain, symptoms, anxiety, and stress
Is a referral required?
No. You can contact us at any time; tell your healthcare provider you’d like to add palliative care to your treatment plan
Yes. A referral is required, and hospice staff can assist with securing a referral from your physician
What are the treatment goals?
Medication education and symptom management, navigating through progression of the illness, support and education for patient and family, advance care planning, and transitioning to hospice, if and when appropriate
Pain and symptom management is key. The patient is always at the center of care, with the goals of helping him/her live comfortably and with a sense of normalcy, respect, and dignity
Does starting this care mean I’m giving up hope?
No. You can continue to pursue the things for which you hope. This includes pursuing curative treatments for your illness alongside palliative care
No. What you hope for may change to focus on comfort, emotional and spiritual peace, and living well at the end of life’s journey
Where is care provided?
Home, inpatient facilities, clinic, community, where available
Wherever the patient resides: home, assisted living facility, long-term care facility, hospital, or hospice house, where available
Will this type of care hasten death?
Does this care mean the doctor has given up?
No. The medical team will continue trying to treat and cure the illness, and palliative care will keep you comfortable
No. The medical team will work together and focus on the reversible causes of pain and symptoms. They are not giving up on you or your comfort
Who pays for services?
Inpatient services are covered as part of the hospitalization, just as other specialists are covered by insurance. Outpatient services are typically billed and covered in a similar way to other outpatient visits
Medicare covers all or most of the services related to the hospice diagnosis. Medicaid and most major insurance companies also offer hospice coverage. No one will be turned down over for inability to pay
Who is involved?
The palliative care team may include a physician, advanced practice providers, social worker, nurses, and chaplain. The team may coordinate care with your primary care provider or specialists
The patient and his/her family work with a multidisciplinary team of experts that may include the hospice medical director, patient’s primary physician, hospice nurse, hospice CNA, hospice social worker, hospice chaplain, hospice volunteers, and hospice bereavement specialist
Who provides the care?
Members of the palliative care team, as noted previously, provide both direct and indirect care
The entire care team: doctors, nurses, CNAs, social workers, chaplains, volunteers, bereavement specialists, and others as needed
Will this service help my family?
Yes. They are part of the support system. Family members are encouraged to participate in palliative care visits as appropriate
Yes. They are an integral part of the support team

Useful Resources

Additional North Dakota Palliative Care Resources

North Dakota Rural Community-Based Palliative Care

North Dakota Palliative Care TeleECHO

Altru Health System, Grand Forks, ND  (Serving Northeast ND and Northwest MN)

Essentia Health-Fargo

Sanford Health (Serving Fargo and Bismarck)

St. Alexius Medical Center- Bismarck