Myth Buster: Palliative Care Is Not Hospice Care
The terms hospice care and palliative care are used interchangeably in many conversations about terminally ill patients and end-of-life decisions. However, while they both involve treating and managing illnesses that will ultimately limit the patient’s life, there are important core differences. If you or a family member are considering palliative care or hospice care, learning about your options ahead of time will ease the decision-making process as the illness progresses.
“It’s never too early to start discussing your long-term goals if you have a chronic or terminal disease,” said Maurice Gross, MD, medical director, Palliative Care and associate medical director, Hospice Care at Abington-Jefferson Health. “Palliative care and hospice care have important roles to play in ensuring your comfort and quality of life.”
Palliative Care – Provided During Active Treatment
Patients can receive palliative care at any time during treatment for a terminal or chronic disease. It’s most commonly provided in a setting like a hospital, long-term care facility or nursing home. The palliative care team consists of doctors, nurses and other caregivers who are focused on treating the patient’s symptoms and making them feel comfortable. It looks at the patient holistically – providing relief for physical pain and support for emotional and spiritual well-being.
An important distinction in palliative care is that the patient does not have to be dying and can receive life-prolonging treatments for their disease. For instance, a person who learns they have terminal cancer can immediately start palliative care while also receiving treatment designed to prolong their life.
“Palliative care is a conversation and a consultation involving the doctor, the patient, and the family,” said Dr. Gross. “It helps everyone involved make decisions about treatment options, living wills, and who will make important decisions if the patient can no longer decide on their own.”
Dr. Gross recommends that the entire family be involved in palliative care. It can help them resolve differences about treatment for their loved one, so that difficult decisions are easier to make in the future.
“Decisions you make about palliative care are never set in stone,” said Dr. Gross. “The patient is always free to change their mind about their healthcare options at any time during their treatment.”
Hospice – Withdrawing Non-Beneficial Care
Hospice care is reserved for terminally ill patients who will no longer benefit from treatment. It’s offered when the person has six months or less to live, assuming the disease progresses as expected. After 90 days in hospice care, the patient will be reevaluated to see if they continue to show decline; if they have not, they may be removed from the program.
Hospice care usually occurs in the patient’s home, or sometimes in a nursing home. The only care the patient will receive is designed to help relieve pain, reduce their unpleasant symptoms and keep them comfortable. They will no longer receive treatment to prolong their life or fight their disease, since these treatments are no longer working.
“When someone decides to receive hospice care, the whole family should be on the same page,” said Dr. Gross. “Everyone should be comfortable with the decision and in agreement that it will help the patient die a peaceful and natural death.”
Like palliative care, patients can always change their mind about hospice care at any point in their treatment. Doctors will support the patient’s decision and provide the level of care the patient desires.
Palliative care and hospice care not only treat the patient, but the entire family as well. Bereavement services and counseling are available to help family members adjust to life without their loved one.
If you or a loved one would benefit from palliative care or hospice care, talk to your doctor to learn more about the programs available.