Understanding Palliative and Hospice Care

Palliative and hospice care help to provide relief for patients from the symptoms and the stress of serious illness. Both involve teams of doctors, nurses and professional care givers. A combined approach includes medications, day-to-day care, and symptom relief administered through a single program. Although these terms are often mentioned together and may have some similar aspects, hospice and palliative care are different.

The role of palliative care

Palliative care acts to fill the gap for the patient who wants or needs comfort in any stage of a disease. In many cases, palliative care will be given alongside life-prolonging therapies like chemotherapy. Palliative care is a comprehensive approach to improve the quality of life for people who are living with a serious illness. The main goals are often to alleviate pain and other symptoms or discomfort associated with an illness or its treatment and to reduce patient and family stress. The care is tailored to the individual based on his/her individual needs and wishes.

It has evolved into a service that provides psychological, spiritual, goal setting and decision-making support. Unlike hospice care, palliative care is appropriate early in the course of the illness, and patients can be simultaneously treated for their condition, including therapies intended to prolong life. Palliative care can provide treatment for symptoms even if the underlying disease cannot ultimately be cured and can only be managed by treatment.

The role of hospice care

In contrast, hospice care is for patients suffering from an incurable illness with a life expectancy of less than six months and is sometimes considered a specialized type of palliative care. The focus is to improve the patient’s quality of life, maintain dignity and make the patient as comfortable as possible during the time they have remaining. Hospice can be provided in many types of settings, including nursing homes, inpatient units, and at home.

A personal experience with palliative care

Several years ago, I witnessed firsthand the amazing effects of palliative care not only on patient outcomes but family interactions. My uncle, who was fighting a blood cancer, was experiencing pain, fatigue, loss of appetite and depression. A team of collaborative palliative care professionals helped to provide greater relief of these symptoms as well as assistance with decision making and emotional support for the family. I can remember how much more comfortable and relaxed my uncle looked as the team prescribed pain medications, as well as other medications to truly address his symptoms. The family, too, was affected by his improved physical and mental status and was grateful for the extra support resources provided by the palliative care team.

Barriers to implementing palliative care may include having no agreed upon criteria for referral, confusion about the difference between palliative care and hospice, insurance coverage, and the comfort level of the health care practitioner to start the conversation with patients and family. It is important to know that these programs are often available and supportive to patients. Recently, I've been exploring palliative care for another relative with a chronic illness and helping them to understand how this type of service might be beneficial. Knowledge is power. We must keep ourselves informed and advocate for ourselves and loved ones.