Physician-led symptom management for any serious illness. Alongside your oncology, cardiology, pulmonology, dialysis, neurology — not instead of. Not hospice. Not “the step before” hospice. A second conversation, running in parallel.
Not sure whether this is the right one? See hospice and palliative side by side →
This is the question we answer most often, so we want it cleared up before anything else. Palliative care is for patients with serious illness regardless of where they are in the trajectory of that illness. It is delivered alongside any other treatment you’re receiving — chemotherapy, dialysis, cardiology follow-up, immunotherapy, anything. The question we ask is not “is this person near the end”; the question is “could this person live better right now if symptoms were better managed and conversations were happening earlier.”
Same team. Pathways palliative and hospice are run by the same physicians and NPs. If the trajectory turns, transition is seamless. And a referral to palliative is not a signal anyone is dying — it’s a signal someone could be living better.
Disease-directed treatment (the chemotherapy, the heart medications, the inhalers) is the specialist’s domain. What lives between those appointments — the symptoms that wear a patient down across weeks — is what palliative is built for.
Cancer pain, neuropathy, post-surgical pain that hasn’t resolved, generalized pain of advanced disease. We titrate the regimen, layer adjuvants, and stay close enough to catch breakthrough early.
Dyspnea beyond what the inhaler does. Anxiety-driven breathlessness. Oxygen titration. The fear that comes with not being able to breathe — which is often as treatable as the breathlessness itself.
Chemo-induced nausea that hasn’t responded to first-line. Refractory nausea of advanced disease. Anticipatory nausea. The combinations and dosing patterns that finally bring this under control.
One of the most commonly reported symptoms across serious illnesses. Distinguishing what’s reversible (anemia, depression, deconditioning) from what isn’t. Pacing strategies. Targeted treatment when there’s a treatable cause.
The emotional weight of living with a serious illness. Existential distress. Sleep disturbance. We screen routinely, treat directly, and refer when the situation calls for more.
The discussions that matter most about what comes next: goals-of-care, advance directives, family alignment, when to call the oncologist, what to do at three a.m. We have these in the home, on your timeline.
Palliative care is condition-agnostic and stage-agnostic. We see patients early in treatment, mid-treatment, between treatments, and after treatment has ended. Below are the most common clinical situations — not an exclusive list.
Pain, fatigue, neuropathy, nausea, anxiety, sleep, advance care planning. We coordinate directly with your oncologist; treatment continues. Particularly valuable from diagnosis forward, not only later.
Class III/IV CHF symptoms despite optimal management. Breathlessness, fatigue, fluid weight, the anxiety of repeated hospitalizations. Goals-of-care conversations earlier so families aren’t making decisions in the ED.
Dyspnea management beyond inhalers. Oxygen titration. Anxiety associated with breathing changes. Coordination with pulmonology. Reducing the threshold-of-fear that drives ED visits.
Symptom burden of CKD — pruritus, restless legs, fatigue, anxiety, fluid management between dialyses. Earlier conversations about whether to start, continue, or stop dialysis — framed by the patient’s actual goals.
Slow-trajectory neurologic disease where symptom load and family-system burden grow over years. Caregiver support. Functional planning. Communication strategies as language changes.
Sometimes the diagnosis isn’t the question — the symptom is. Persistent pain, intractable nausea, hard-to-manage breathing, anxiety wearing the patient down. Palliative is sometimes the team that finally gets these things under control.
Not sure if palliative is right? The easiest check is to ask whether life with this illness could be measurably better with a clinician focused entirely on symptom and decision support. If the answer is “probably yes,” call 800.939.1855. Our palliative team can do a no-pressure consult and coordinate with the patient’s physician on whether to start.
Palliative is less about frequent visits and more about the right clinician at the right moment. Visits are typically once or twice a month for stable patients, more often when symptoms escalate or a transition is being navigated. The 24/7 line is the through-line.
Board-certified physician oversight. Order writing, complex symptom management protocols, peer-to-peer communication with the patient’s oncologist, cardiologist, or specialist. The medical director is reachable twenty-four hours a day.
Your day-to-day clinical face. In-person visits, telehealth follow-ups, medication adjustments, education for the patient and family, communication with your other physicians. Most patients see the NP first.
For complex symptom flares, in-home assessments, line care if needed, hands-on education for the family. Especially valuable in cancer pain crises and heart-failure exacerbations.
Goals-of-care navigation, advance directive completion, family-system support, community resource referrals, insurance and benefits navigation. Often the most-mentioned-by-name team member.
Available regardless of faith tradition or whether you have one. Some patients want extensive spiritual support during serious illness; some want none; some find their way later. Always optional.
For stable check-ins, virtual visits work well and patients prefer them. For symptom escalations and new diagnoses, in-home is better. The team flexes between both.
Most palliative visits are billed to Medicare Part B or commercial insurance as physician/NP visits. Coverage details depend on the specific plan, and we verify at intake before the first visit. Patients do not pay separately for the team coordination — only for the billable clinical encounters. Our intake team will tell you exactly what to expect.
The pain that broke through. The breathing that’s worse than yesterday. The phone call from a family member who needs to talk through whether this is the moment for hospice. The 2 a.m. anxiety attack. Palliative is the team that picks up the phone for those moments and either talks them down, adjusts the regimen, comes out for a visit, or coordinates with your specialist on what to change.
Breakthrough pain, intractable nausea, escalating breathlessness. Same-day or same-evening dose adjustments. New medications called in to your pharmacy. A nurse visit if hands-on assessment is needed.
Should we go to the ED? Is it time for hospice? Should we stop the chemo? What does the oncologist actually mean by “a few months”? Our NPs and physicians have these conversations every day.
A change in symptoms often means a change in the regimen of multiple physicians. We do the loops — the oncologist, the cardiologist, the PCP, the home health team. Without that, the patient becomes the coordinator, which is impossible.
Same team, same chart, same nurses, same medical director. The transition from palliative to hospice is a paperwork change and a benefit change — not a change in who is taking care of the patient.
Palliative care is the slow version of the conversation. We start it years before it has to happen, so the family doesn’t have it in an ED hallway.
— From the Pathways team manual.
The most common worry we hear: “does this mean we’re giving up?” No. Adding palliative does not mean stopping anything else. It means adding a team focused on the part of serious illness no other physician has the time to focus on.
Yes. They remain the attending for the disease-directed treatment. We handle symptom management and coordinate with them — not around them. Most specialists welcome palliative involvement because it lets them focus on the disease while we handle the day-to-day.
No. Hospice has eligibility criteria (six-month prognosis if disease runs its course, election of comfort over curative care). Palliative has neither. A patient on active cancer treatment, on dialysis, in cardiac rehab — can all be on palliative.
Most palliative visits are billed as physician/NP encounters to Medicare Part B or your commercial insurance — the same way an oncology or cardiology visit is billed. Our intake team verifies your specific plan and tells you what to expect before the first visit.
Typically once or twice a month for stable patients. More often during symptom escalations, treatment changes, or major transitions. The 24/7 line is the constant; the visit cadence flexes.
You can stop at any time. There’s no contract, no penalty, no commitment. Many patients add palliative for a few months while symptoms are bad, step away when things stabilize, and come back later if needed.
Yes. Palliative is independent of any single specialist. If your oncology team changes, palliative keeps going. The team becomes a steady through-line across whatever happens with the rest of your care.
Call 800.939.1855 and ask for palliative. Our intake nurse will ask about the situation, talk to your physician’s office, and schedule a no-pressure first visit. Or your physician (oncologist, cardiologist, PCP) can send a referral directly.
A palliative patient may also be on home health (for skilled recovery needs) or transition into hospice (if trajectory turns). But many are on palliative alone — through long, stable phases of serious illness — and never need the other two. The team carries across without handoff.
Medicare-certified, intermittent skilled care after a hospital stay, surgery, or for managing a chronic condition. The goal is recovery and independence at home.
See Home Health →For anyone living with a serious illness who wants relief and a plan — alongside whatever treatment you’re pursuing. Call us and we’ll help you figure out what fits.
End-of-life care focused on comfort and presence. For patients whose disease can no longer be cured but whose remaining time can still be lived well at home.
See Hospice →We come to you. We stay with you. Whatever you need — and whatever comes next.
Whether you’re a specialist with a patient whose symptoms aren’t coming under control, a PCP wondering if it’s time, a patient who’s been told to consider palliative, or a family member at the end of a long week — one call. A palliative NP or our medical director picks up, asks the right questions, and tells you exactly how this would work for this patient.
