Hospice and Palliative Care

Obtaining care is the most important issue for dying people. Hospice and palliative care are very similar for that reason. Many people have heard of hospice and are aware of the general services hospice care provides. Some people confuse hospice care and services with palliative care.

Hospice care is provided to patients with terminal illnesses such as cancer or heart disease. It provides symptom and pain management, spiritual support, emotional support, and focuses on the patient's needs and wants at the end of their life. The overall goal of hospice care is to focus on the patient's quality of life when they have reached the final stages of their terminal illness.

Hospice care provides palliative care, which specializes in providing patients with pain, symptom, and stress relief from a serious or chronic illness such as cancer, kidney failure, Alzheimer's, Parkinson's, congestive heart failure (CHF), and the like. The term palliative care refers to any types of care or treatment that will help diminish or prevent symptoms for patients suffering from a chronic illness. The ultimate goal of palliative care is to provide the patient and family with an improved quality and quantity of life. 

 

How do Hospice and Palliative Care Differ?

Hospice Care is typically administered at the patient's home and overseen by a team of hospice professionals, however the family caregiver and visiting hospice nurse are the main components. Although hospice can be administered 24/7 at a nursing home or hospice center, it is typically not the norm.

Palliative Care is typically administered at a hospital, nursing home, or extended care facility where the patient would receive their first treatment. It is typically administered and overseen by a team of doctors, nurses, and other medical caregivers. Although palliative care can be administered at the patient's home, it is typically not the norm.

To receive hospice benefits from insurance or be accepted into a hospice program, a patient must be deemed terminal and have less than six months to live. Palliative care does not have any restrictions for time. A patient, whether terminal or not, can receive palliative care for any illness at any time. 

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Who Uses Hospice and Palliative Care?

A patient who has reached the final stages of a terminal illness would typically use hospice care for comfort and quality of life. Hospice care is typically offered at home where any hospice professional can visit the patient to administer pain relief, emotional support, and spiritual support. Palliative care is a part of hospice care, which pinpoints and works to solve any issues with pain.

There are some hospice centers who admit patients if circumstances don't allow a patient to remain in their home. A patient who has a serious or chronic illness would typically use palliative care for comfort and life-prolonging treatment options. Palliative care is offered in the hospital or facility where the patient is receiving treatment for said illness. Emotional and spiritual support can also be arranged for someone in palliative care.

Before choosing a hospice center or deciding if hospice is right for them, it is important that a patient fully understands their illness and prognosis. A person who is deemed having six months or less to live is eligible for hospice. Hospice professionals and services do not offer "cures" of any kind. Their job is to help the life-death process transition as smoothly and worry free as possible for the patient and his/her friends and family.

 

What are the Typical Services Offered for Hospice and Palliative Care?

Physical Care: It is so often a dying person's fear to suffer in pain towards the end of their life. Hospice workers understand this fear and make pain management one of the top priorities. Pain and symptom relief/prevention is the heart of what hospice is for and pain is often controlled by over-the-counter medications, narcotics, and steroids. Federal guidelines and state laws require hospice workers to make every effort to control pain and symptoms. Pain and symptom relief/treatment is the most important part of palliative care. The difference is that pain and symptom treatment in palliative care is meant to prolong a patient's life.

Emotional Support: Aside from pain management, a patient's stress/tension level is another concern hospices address. High stress/tension levels can lead to a quicker decline. A vital service offered by hospice is emotional support for both the patient and the patient's family. A counselor, social worker, volunteer, or even a music/art therapist can help soothe the patient with whatever emotional stress/needs they encounter. Volunteers may help nurses bring meals, talk to families, or talk to patients who have little to no support from family. Massage therapy can also help with stress relief and pain control. These types of support are also offered to palliative care patients, which can help them cope with the stress of their illnesses.

Spiritual Support: A chaplain or rabbi can help patients with after-death fears, questions, and tensions. Having spiritual support for the terminally or chronically ill is an important component and can reduce a patient's stress level tremendously. Having spiritual support can also help the patient say goodbye to their family and take care of any "unfinished business" before death. After the patient passes away, the chaplain and rabbi are part of the bereavement support system offered to surviving family members.

Support groups, letters, phone calls, and visiting during the first year are typical follow-ups a family can expect from a counselor or volunteer after their loved one has passed.

 

Patient advocacy is the core reason for hospice and palliative care. The team of hospice/palliative care professionals works to help the patient become as comfortable as possible—whether they are dying or not. Both types of care create individualized plans for suffering patients and may change on a frequent basis. Both types of care can be covered by medical insurance, and other programs may offer financial help. 

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