Palliative Care Is About Changing the Conversation

Is he still Full Code?”

“Is this patient palliative?”

“Did you de-escalate the MOLST?”

These are common questions in serious illness care, but they can also reveal a misunderstanding of what palliative care is meant to do.

Palliative care is not about changing a code status.

It is about changing the conversation.

What Palliative Care Is Really Meant to Accomplish

The success of a palliative care consultation should not be measured by whether a patient becomes DNR or whether a MOLST form changes.

The real measure is whether the patient and family leave the conversation with greater clarity.

Do they understand the medical situation more clearly?

Were their concerns heard?

Were their values taken seriously?

Does the care plan reflect what matters most to them?

Those are the questions that matter.

Sometimes the Decision Changes. Sometimes It Does Not.

A thoughtful palliative care conversation may lead a patient to choose DNR status.

It may also lead them to remain Full Code.

Either outcome can be appropriate.

The purpose of palliative care is not to steer someone toward a predetermined decision. It is to make sure the patient has enough information, support, and understanding to make an informed choice that reflects their wishes.

That distinction matters.

Palliative Care Is Not Less Care

One of the most persistent misconceptions about palliative care is that it means doing less.

It does not.

Palliative care is about providing the right care.

That can mean better symptom management, clearer communication, more thoughtful care planning, and stronger alignment between treatment decisions and the patient’s goals.

It can also mean helping families understand what to expect so they are not forced to make important decisions in the middle of a crisis.

Better Conversations Lead to Better Care

When patients and families understand their options, they are better equipped to make decisions that feel informed and personal.

When healthcare teams understand those wishes, care becomes more coordinated.

And when everyone is working from the same understanding, the patient is more likely to receive care that reflects who they are and what they value.

That is the heart of palliative care.

Not reducing care.

Not changing code status for the sake of changing it.

But creating clarity, honoring choice, and making sure the care plan truly belongs to the person receiving it.

At Varahe Health Services, we believe palliative care should help patients, families, and healthcare teams move forward with greater understanding, control, and dignity.

About the Author: Dr. Geetha Chilakamarri is the Chief Medical Officer and Co-Founder of Varahe Health Services and is triple board-certified in Geriatric Medicine, Family Medicine, and Palliative Care Medicine.