After being in and out of the hospital for the greater part of a year, former first lady Barbara Bush announced her decision to focus on comfort care instead of seeking additional medical assistance. This highlights a choice those with a terminal illness will eventually have to make. 

"At some point, all individuals will face some kind of illness for which failing health cannot be cured," said Dr. Diane Portman, who heads up the Supportive Care Medicine Program at Moffitt Cancer Center. "This may not mean that the patient’s life will end immediately, but that the treatments that can be provided are not working to get them better. And now they may want to shift from a focus on cure to staying comfortable, with ongoing support for quality of life.” 

She says people with failing health need care in four areas:

• Physical comfort
• Emotional needs
• Spiritual issues
• Practical tasks 

The Supportive Care Medicine Program, which encompasses services including Integrative Medicine, Behavioral Medicine and Palliative Care, concentrates on relieving the pain, distress and other symptoms that can accompany serious illness. It may be provided with curative and life-prolonging treatment. While most medical treatments are aimed at the disease, Supportive Care Medicine directs its efforts at minimizing the overall impact that being seriously ill has on patients and families. It is medical care that considers the whole person, not just the disease. 

Supportive care medicine focuses on:

• Well-being
• Ensuring that all reasonable treatment options are explored
• Having patients and families make informed health care decisions
• Maximizing comfort and minimizing unwanted hospitalizations or treatments
• Patients living the best life possible with a serious illness

Portman says that when a cancer patient’s oncologist identifies that aggressive treatments may no longer be beneficial, the care team conducts goals-of-care discussions with patients and their families. They review their wishes at various stages of illness and provide or arrange for care that is aligned with the needs, values, and priorities of the patients and their families and caregivers.

Involving the Supportive Care Medicine team is often helpful at the time of diagnosis, when symptoms are present. Patients with more advanced illness also benefit from supportive care, and the benefits are even greater for those patients and their family members who seek help earlier.