When my mother was diagnosed with biliary cancer at the age of 89 it was relatively easy to choose our next steps because I had worked as a hospice physician for many years and understood the options that were available to her. In addition I had already held many conversations with her over a period of five years about what type of care she wanted to receive at the end of life so we were well prepared for the situation that faced us.
But most people don’t have the advantage of personal knowledge about end-of-life options and many also have never thought or talked about their wishes for care in such a situation. Without information many families may make hasty decisions to engage aggressive treatment for their loved one because they don’t know what else to do. These patients may tragically be subjected to treatment they do not want simply because of a lack of knowledge and preparation.
To be fully prepared for whatever the future may bring you need to know some basic information about palliative care and hospice. You can begin your education by tuning in to a free web series titled “Demystifying Palliative Care” at eoluiversity.com/palliative.
You’ll learn that both hospice and palliative care are team-oriented approaches to care that focus on the whole person with an emphasis on physical, emotional and spiritual needs. Both palliative care and hospice focus on treating symptoms and keeping the patient comfortable and both also consider the wellbeing of the family.
But there are some key differences between palliative care and hospice that you’ll need to understand in order to make the best decision for your loved one. Here are four of those differences:
- Time Frame
Palliative care can begin early in the course of a disease so consider it as soon as your loved one is diagnosed with a potentially life-limiting illness. Hospice care is appropriate when the patient has 6 months or less to live.
Palliative patients can continue to receive full treatment for their illness at the same time they are receiving palliative care. However, patients are appropriate for hospice when they have stopped all treatment for the illness.
Palliative patients are not necessarily at the end of life and can receive care for as long as necessary. Hospice patients are considered terminal and will be preparing for the end of life with the hospice staff. Some palliative patients go on to be admitted for hospice care eventually and the palliative care team can assist with that decision when necessary.
- Goal of Care
The palliative care team has a goal to assist the patient during the course of serious illness in any way needed, particularly with physical, emotional and spiritual issues that are not addressed by the treatment team. The goal of hospice care is to assist the patient and family through the dying process, providing symptom management and support as needed.
In my mother’s case when she was diagnosed with biliary cancer she might have been a good candidate for palliative care to help her with her symptoms if she had been younger and healthier overall. A patient newly diagnosed with cancer who is starting treatment would benefit from the services of the palliative care team throughout the entire course of care.
But Mom was not a candidate for any treatment for her cancer because of her age and frailty so we chose to admit her for hospice care. We understood that she was at the end of her life and she was ready emotionally and spiritually to prepare for her last days.
Hospice was a perfect choice for Mom because she was able to stay in her own home and receive visits there from the hospice staff. They made sure she stayed comfortable and safe in her home until she needed me to come and provide around-the-clock care for her.
If you have an ill loved one and are not sure whether hospice or palliative care would be appropriate you can request a palliative care consult. The team will evaluate your loved one and make a recommendation for the best care to choose. Even if you don’t know what to do it is most important that you ask for a consultation because either choice—hospice or palliative care—is far better for your loved one than choosing neither. Be proactive, ask questions, and request help earlier rather than later. You won’t regret taking action but you may regret doing nothing.
For further information, Dr. Wyatt recommends this series: End of Life University.
Dr. Karen Wyatt is a hospice and family physician who writes extensively on spirituality and medicine, especially at the end-of-life. She is the author of “The Tao of Death” and the award-winning book “What Really Matters: 7 Lessons for Living from the Stories of the Dying”. She is a frequent keynote speaker and radio show guest whose profound teachings have helped many find their way through the difficult times of life. Learn more about her work at www.karenwyattmd.com. Connect with Karen Wyatt at karenwyattmd.com, on Facebook and on Twitter .