"People should start preparing for death now because it´s coming.I think that you can develop the confidence that you will do what´s right when the time comes. You can believe in yourself and trust yourself if you have prepared.And part of that means reaching out when you need help and knowing your limitations."–Dr. Francine RainoneWelcome to another episode of Amorte where we explore subjects surroundoing death education, loss and grief.  Today my guest is Dr. Francine Rainone. In this episode we will explore  palliative care. What is Palliative Care?When is the appropriate time to consider palliative care?What are the goals of palliative care?What are some open ended questions that can be asked to explore the need for palliative care?What are the principles of palliative care?What are some important end of life questions?When should palliative care be started?When should end-of-life conversations occur?How do you help families talk about end of life care instead of continuing medical procedures?Dr. Francine Rainone is a retired Hospice and Palliative Medicine physician. She has practiced in both rural and urban settings in the U.S.  For ten years she was the Medical Director of the Palliative Care service at Lourdes hospital in Binghamton NY. She is also a long-time practitioner of Buddhism and a Mindfulness Meditation Teacher. She believes that practice occurs every moment of our lives, and that preparing for death is simply another important part of life.Americans are scared to death of dying. And with good reason. While rarely easy under any circumstances, we make dying a lot harder than it has to be. A large majority of Americans still die in hospitals or nursing homes. Many suffer poorly controlled pain or other physical miseries and endure their final days feeling undignified and a burden to others.When someone we love is diagnosed with a life-threatening condition, the worst thing we can imagine is that he or she might die. The sobering fact is that there are worse things than having someone you love die.People often confuse Hospice and Palliative Care.Hospice is intended for the last six months of end of life care and palliative care treats anyone with a chronic serious illness. They share the same philosophy which is physicians who are treating people with a serious illness should be treating the whole person, should be respecting their wishes and should be enhancing the quality of life.People who come to palliative care may have a terminal illness, may be being treated for a terminal illness or may have a chronic illness that causes their death or it may lead to something else. People that have been treated successfully for cancer but continue to have symptoms because of the treatment. Palliative care addresses the patient and family and gives them all the information they need so that they can make informed choices about what they want. It also includes symptom management to prevent, anticipate and treat the symptoms that occur. Pain management is another small part of palliative care. Most people are not trained on how to manage pain. Expectations should be realistic. You can never guarantee it might disappear completely but offer a way of living with their pain and is not necessarily their enemy. Meditation can be a great tool. Recommended books:Mindfulness meditation for pain relief Jon Kabat ZinnThe best care possible Ira ByockDying with confidence Buddhist Anyen Rinpoche .