Jerusalem Post

ByDR. ITAY GAL

Palliative care is a branch of medicine intended for patients with terminal illnesses, from the moment of diagnosis until the end of life.Palliative care, which has been gaining momentum in recent years, offers patients with life-threatening illnesses support and guidance throughout their illness, with as little suffering as possible.
Palliative care is a branch of medicine intended for patients with terminal illnesses, from the moment of diagnosis until the end of life, whether alongside curative treatment or in situations where no further curative treatment can be offered.
Dr. Naama Asher Berger, head of the field at Clalit Health Services in the Dan-Petah Tikva district, explained how even when there is no hope for a cure, it is possible to live a life full of meaning, with minimal suffering, while preserving the patient’s values, beliefs, and wishes.

Palliative care improves quality of life
Ayelet knew her time was short. Only a few months after being told her cancer had returned, doctors made it clear that there were no longer treatment options for recovery. The pain was severe, breathing required effort, and the fear of death was tangible.

Then palliative care entered the picture. The innovative treatment she received at home combined pain relief medication and emotional support, allowing her not only to say goodbye with dignity but also to fulfill two last wishes: visiting the beach she hadn’t set foot on in years, and having a festive dinner with her entire family. She died two weeks later, peacefully and surrounded by love.

The goal is neither to prolong life at all costs nor to shorten it, but to ease physical, emotional, and mental suffering, and to help the patient and their family navigate the illness in a humane and respectful manner.
While palliative care was once known primarily in hospices abroad, it entered Israel several years ago and has expanded significantly in recent years, with clinical specialization in nursing and physician training, as well as the establishment of dedicated hospital units and equivalent services in health clinics.
According to Dr. Asher Berger, a palliative care specialist and field coordinator at Clalit in the Dan-Petah Tikva district, the change this field has brought has been fundamental.
“Even when medicine can no longer save or prolong life, we can preserve the quality of life that remains, ease suffering, and help the patient find meaning until the very last moment of parting. Meeting people at this stage of their lives teaches us important lessons in perspective and reminds us what really matters,” Berger said.

However, Dr. Asher Berger admitted, the decision to specialize in palliative care was not simple.
“I began specializing in family medicine, but the routine and workload in the public system didn’t allow for deep conversations with patients. The burnout pushed me to seek another path, and I found myself drawn to palliative care. While it doesn’t offer the chance to save lives, it fosters a deep emotional connection with patients, accompanied by a touch, a hug, and tears that fill the heart.”
Palliative care does not focus only on physical relief through painkillers and other medical measures. It also includes emotional support, psychological counseling, and assistance to the patient’s surroundings.
“The family of a terminally ill patient goes through immense upheaval,” Dr. Asher Berger explained. “The beauty of our profession is that the family is an integral part of the care itself. We are there for them too, with teams of social workers, psychologists, nurses, and doctors supporting everyone together.”
Tailoring care to patients' needs
The palliative approach emphasizes tailoring care to each patient’s unique needs. Sometimes this involves advanced pain management, sometimes measures to ease shortness of breath, and in other cases, nutritional support or help with sleep issues.
Alongside this, great importance is placed on personal and family space and setting treatment goals. Patients are asked whether they prefer to stay at home or in an institution, what activities or dreams they would like to fulfill, and how to manage their final period so that it is as peaceful and meaningful as possible.
“We teach medical teams and families to recognize the patient’s needs early, even when they already have difficulty communicating,” said Dr. Asher Berger. “Easing suffering is not just a technical matter; it requires sensitivity, listening, and sometimes understanding what the patient does not say in words.”
Despite the emotional difficulty of working with patients nearing the end of their lives, Dr. Berger described the deep sense of fulfillment in the profession.
“There are moments when you see the relief in the eyes of someone who no longer suffers from pain, or the smile of a family member thanking you for the extra time they gained toward the end. These moments remind you why you chose this path.”
In Israel, palliative care is currently provided in a variety of settings, from outpatient clinics for mobile patients through health funds to some hospital outpatient clinics.
In more severe cases, there are inpatient facilities in geriatric institutions, as well as home and inpatient hospice units. Palliative care is part of Israel’s national health services basket and is provided free of charge to every citizen, with referrals made through the treating physician.
The field still faces significant challenges: a shortage of professionals, a lack of public awareness, and the difficulty patients and families sometimes have in accepting the idea of care that is not aimed at curing. But awareness of palliative care is growing, and its core message is sinking in:  it is possible to continue living even alongside a life-threatening diagnosis, and the end of life can be a time of relief, dignity, and meaning.
“It is appropriate that every person with an incurable illness should receive palliative care from the moment it is clear the disease cannot be cured,” Dr. Berger concluded. “This care allows us to prepare, treat symptoms in time, listen to the patient, and ensure they end their life in a way that matches their wishes and values. The end matters too, and it can be better than we think.”