Q. What is the difference between palliative and hospice care? We're trying to explore all possible options for our mother who has advanced cancer.
Palliative care is an approach to care that improves the quality of life of patients and their families who are living with severe illness. Palliative care prevents and alleviates physical, psychological and spiritual suffering through the early identification, correct assessment and treatment of pain and other problems. The goal of palliative care is to improve overall quality of life through a holistic approach to care that focuses on relieving symptoms and reducing stress. Palliative care includes the needs and well-being of the patient, caregivers and family members. Palliative care does not mean the patient is dying.
Palliative care can be pursued at diagnosis, during curative treatment and follow-up, and at the end of life. The American Society of Clinical Oncology recommends that people with cancer receive palliative care as early in their diagnosis as possible. Cancer ranks 2nd as the disease most in need of palliative care. When palliative care is provided early, people with cancer tend to have a better quality of life, enhanced mental health, faster recovery and increased survival rates. Research has shown that palliative care helps patients adhere to their treatment plan and reduces the financial burden of care. Additionally, it strengthens coping skills and enhances human dignity. 100% of the studies conducted on palliative care report that it improved quality of life for patients and their families.
Most major treatment facilities have a palliative care department. Patients can request that a palliative care professional be assigned to their medical team. While palliative care is a medical specialty, most palliative care is provided by the primary medical team – nurses and doctors. Palliative care activities include communication, medical decision-making, symptom management, and psychosocial and spiritual support.
Many people confuse palliative care with hospice care because palliative care was born out of the hospice movement.
Hospice care is a specific type of palliative care that is provided in the final weeks or months of life when a patient has decided to stop treatment for the disease or has no other options. Hospice care is comfort care with no curative intent. Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person’s illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.
Hospice care can be offered at home or a facility such as a nursing home, hospital, or even in a separate hospice center. Hospice care brings together a team of people with special skills — among them nurses, doctors, social workers, spiritual advisors, and trained volunteers. Everyone works together with the person who is dying, the caregiver, and/or the family to provide the medical, emotional, and spiritual support needed. A member of the hospice team visits regularly, and someone is usually always available by phone — 24 hours a day, seven days a week.
Although hospice provides a lot of support, the day-to-day care of a person dying at home is provided by family and friends. The hospice team coaches family members on how to care for the person. Families of people who received care through a hospice program are more satisfied with end-of-life care than those who did not have hospice services. Also, hospice recipients are more likely to have their pain controlled and less likely to undergo tests or be given medicines they don’t need, compared with people who don’t use hospice care.