Palliative Care and Hospice Care Similar But Different
By Kathy Hubbard
They say that great minds think alike. So, Paul Graves, the facilitator for the Geezer Forum, and I must both have great minds. This week’s forum was centered on palliative care and defining its role in healthcare. I had already chosen palliative and hospice care as this week’s subject. Unfortunately, I can’t report on the forum because, as I’m writing this article, it hasn’t occurred yet.
I will go out on a limb, though and suggest that we’ll cover the same territory. As most of you generally know, hospice care is ordered when a patient has been diagnosed with a terminal illness and has less than a year to live if the illness runs its natural course.
“At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments,” explains the National Institute on Aging. “Hospice is designed for this situation. The patient beginning hospice care understands that his or her illness is not responding to medical attempts to cure it or to slow the disease’s progress.”
Thinking about hospice, I remembered a conversation I had with Bonner Community Hospice Volunteer Coordinator, Lissa DeFreitas, a couple of years ago. She told me about a patient who suffered from a multitude of complications from diabetes and was put into hospice care.
The hospice team, consisting of doctors, nurses, social workers and spiritual advisors worked together to come up with a plan to give this patient the medical, emotional and spiritual support needed to live the last of his days in comfort. But, and DeFreitas said it’s not unusual, the extra care was just what he needed to improve the quality of his daily life.
This team made sure the patient was eating, and more importantly eating the right foods. They put him on a low-impact exercise routine that he was physically able to perform. The medications made him feel better, his mental attitude improved and low and behold, he actually graduated out of the hospice program.
This type of feel-good story happens. I have no idea how much longer the man lived, or if he is still living. But, I will assume he went into a palliative care program and I’ll let NIA explain what that is:
“In palliative care, you do not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. Over time, if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities. Palliative care could transition to hospice care or the palliative care team could continue to help with increasing emphasis on comfort care.”
The palliative care team is similar to a hospice team. Working with the patient, family and specialists they provide social, emotional and practical support. As such, they’re made up of palliative care specialist doctors and nurses, and will include others such as social workers, nutritionists and chaplains.
They also say that palliative care can be helpful at any stage of illness and is actually best provided on the onset of the disease. What do they mean when they say serious illness? They’re talking about heart failure, chronic obstructive pulmonary disease, cancer, dementia, Parkinson’s and many others.
“In addition to improving quality of life and helping with symptoms, palliative care can help patients understand their choices for medical treatment,” NIA says.
Looking at a comparison chart on NIA’s website the differences seem to be basic. Basically, you can choose hospice when it’s determined that you generally have less than a year to live. When you enter a hospice program you will no longer receive treatment to cure your illness. You can choose to receive medications to manage your symptoms and maintain your highest quality of life.
Now bear in mind, if you have conditions that are not attributed to your illness you’ll still receive your medication. Think high blood pressure. If you suffer from hypertension and cancer, you’ll receive your high blood pressure meds, but not chemo therapy.
Depending on your insurance plan, palliative care costs may be covered. Hospice care is covered by Medicare, Medicaid and most private insurances. I also want to point out that choosing hospice care doesn’t have to be a permanent decision. At any time you choose to restart curative treatments you are able to do so.
Families of patients who entered a hospice program are most likely to be satisfied with end-of-life care than those who didn’t. Think about it.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at [email protected].