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Understanding Hospice & Palliative Care

Friday, April, 29, 2011

Hospice care: A journey of dignity and peace

Hospice is a philosophy of care that offers comfort and peace to terminally ill patients and their families.

The focus of hospice care is neither to prolong life nor to hasten death but to ease pain and other symptoms while allowing the patient to remain alert in order to enjoy meaningful interactions with friends and family during their remaining days. Often, when a life-limiting condition reaches its most advanced stages, curative measures can be invasive but not productive, compromising the patient’s quality of life without having a significant impact on the disease or the patient’s longevity.

To be admitted to hospice, a patient must have a prognosis generally of six months or less, have elected to cease curative treatment and be referred by a physician.

Although perhaps most commonly associated with cancer, hospice care can benefit patients of any age who are coping with any life-limiting condition, including heart and lung disease, Alzheimer's, Parkinson's, ALS, diabetes, multiple sclerosis, HIV and AIDS as well as kidney and liver diseases.

Sometimes patients and families are afraid to consider hospice because they equate the choice with giving up hope and refusing further medical care. In fact, hospice patients continue to receive expert medical care from an interdisciplinary team that includes physicians, registered and licensed practical nurses, certified nursing assistants, medical social workers, bereavement counselors, chaplains and volunteers – all of whom are specially trained in end-of-life care. 

There is no predetermined regimen of care for hospice. Instead, hospice professionals work closely with the patient and their family to develop an individualized plan of care to manage symptoms and minimize pain as well as to address the emotional and spiritual needs of the end-of-life experience. 

Hospice care can be provided wherever a patient calls home, whether it is a private residence, assisted living facility, nursing home or hospital. For patients whose care cannot be effectively managed at home, inpatient facilities like the Gordon Hospice House and the S. Mitchell Mack Hospice House provide 24-hour nursing care in a warm, homelike environment.

Caregivers and families are as much a part of the hospice care plan as the patient, and they receive support from the hospice team every step of way, including ongoing bereavement counseling after their loved one’s journey has reached its end.

Palliative care: Comfort when it’s needed most

As such, the focus of palliative care is to relieve the severity of pain and other symptoms such as anxiety, agitation, nausea, fatigue and shortness of breath. Palliative care can also help patients manage medications effectively, reduce hospital admissions, achieve physical therapy goals and more.Palliative care is a relatively new medical specialty that evolved from hospice care. As hospice became more mainstream, the medical community began to recognize that all seriously ill patients – even those not facing a terminal diagnosis – could benefit from better pain and symptom management.

Because the plan of care and the method of delivery are customized for each individual, palliative care can be used to manage the symptoms associated with a wide range of conditions, including congestive heart failure, diabetes, COPD and cancer.

Palliative care can be provided in the patient’s home, at an assisted living or long-term care facility or in a hospital setting. The palliative care team works closely with family caregivers to ensure they know exactly when to give medications, how much to administer and that they have support whenever they have questions. The patient’s general physician is also a key member of the team and generally is very involved in coordinating services and care.

The primary difference between hospice and palliative care is that palliative care can be provided at any stage of an illness and in conjunction with curative treatments. Many patients who choose to receive palliative care do not have a limited prognosis. In fact, by controlling pain and other symptoms, palliative care can help patients tolerate more aggressive curative measures that will help prolong their lives. 

Different specialties with a shared focus

Both hospice and palliative care are holistic practices. Caregiving professionals focus on optimizing overall quality of life for the patient and their family, not just addressing the disease its effects.

The plan of care is designed to meet the patient's physical needs as well as their emotional and spiritual needs, with the purpose of helping those who are coping with serious chronic or life-threatening medical conditions live each day to the fullest.

Getting started

There's no need to wait for your loved one's physician to broach the subject to begin the conversation about hospice or palliative care. 

If you feel one of these options might be a good choice – whether now or in the future – don't hesitate to share your thoughts with your physician and ask any questions that may be on your mind. 

You can also initiate the referral process yourself either by contacting the Hospice & Palliative Care of Iredell County office nearest you and asking to speak with our intake specialist or by using our online inquiry form. We'll provide more information about our services and work with the patient's doctor for certification into our program.

The costs of hospice and palliative care are covered by Medicare, Medicaid and some private insurance policies. Even in cases when services are not covered by insurance, as Iredell County’s only nonprofit provider, HPCIC is able to offer care to all patients regardless of their ability to pay.

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