MANAGING CARE( continued)
BOTH palliative care and hospice care are focused on relief from symptoms, including pain and stress. Even on hospice, when a patient is not being treated curatively, they receive medical care that is helpful and contributes to comfort, such as blood pressure medication.
BOTH aim to improve quality of life and dignity for the patient and the family.
BOTH are made up of teams that include a physician, nurse, social worker, nutritionist, and volunteer visitors, and may also include music, art, and massage therapists.
BOTH include the service of helping patients and families do advance care planning.
BOTH palliative care and hospice care recognize dying as part of the normal process of living. Neither palliative nor hospice care hastens or delays death.
BOTH result in decreased hospitalizations and decreased use of unhelpful services, and in the patient and family’ s higher perceived quality of care and quality of dying( often seen as“ not dying in the hospital”).( See research studies by Mitchell et. al., 2007; Teno et. al., 2011).
An Internet perusal of hospice care research identifies numerous references supporting the premise that palliative care and hospice care do not hasten death:
1.“… hospice enrollment is not significantly associated with shorter survival; for certain terminally ill patients, hospice is associated with longer survival times.”( Journal of Pain and Symptom Management, March 2007)
28
2.“… patients with terminal cancer that disenrolled from hospice care had significantly higher rates of hospitalizations … than patients who remained under the care of hospice.”( Journal of Clinical Oncology, October 1, 2010)
3. Researchers found that patients receiving palliative care reported a higher quality of life through the final course of their illness.
Differences Between Palliative Care and Hospice Care
When the care begins: Palliative care can begin at any point in a person’ s disease process and can be provided concurrently with curative treatments. A referral for palliative care is not dependent upon prognosis or life expectancy. In fact, palliative care can help patients understand treatment options over time and throughout their disease.
Hospice care is for people in the final phase of life-limiting illness when life-saving treatment no longer works or is wanted, and the physician believes that the person has six months or less to live if the illness were to run its natural course. The patient who agrees to hospice understands that their illness is not responsive to treatments that intend to slow or cure it. Provided that a proper re-evaluation is conducted and appropriate hospice eligibility criteria are met, hospice services can be renewed beyond the initial six months. Likewise, a person could choose to discontinue hospice care and re-enroll at a later date.
Who provides the care: Palliative care is provided by a healthcare team of doctors, nurses, and other specialists who work with the patient’ s current treatment team.
Hospice care is provided by a designated hospice multidisciplinary healthcare team of practitioners: nurses, doctors, social workers, spiritual counselors, massage therapists, creative arts therapists, and trained volunteers. In some cases, if the patient has had a palliative care team, those practitioners continue to provide services but in the new role of hospice care. A hospice team member is available by phone 24 hours a day, 7 days a week.