Difference between palliative care & hospice?

Jolie, BSN · Sep 21, 2008

http://www.caringinfo.org/LivingWithAnIllness/PalliativeCare.htm

To palliate means to make comfortable by treating a person’s symptoms from an illness. Hospice and palliative care both focus on helping a person be comfortable by addressing issues causing physical or emotional pain, or suffering. Hospice and other palliative care providers have teams of people working together to provide care. The goals of palliative care are to improve the quality of a seriously ill person’s life and to support that person and their family during and after treatment.

Hospice focuses on relieving symptoms and supporting patients with a life expectancy of months not years, and their families. However, palliative care may be given at any time during a person’s illness, from diagnosis on. Most hospices have a set of defined services, team members and rules and regulations. Some hospices provide palliative care as a separate program or service, which can be very confusing. The list of questions below provides answers to common questions about the difference between hospice and palliative care.

Learn More

National Hospice and Palliative Care Organization

VickyRN, MSN, DNP, RN · Sep 21, 2008

Thank you very much. This link and information are very helpful :)

shrinky · Sep 22, 2008

It is said that all hospice patients are palliative care but not all palliative care patients are on hospice. Palliative care can be provided to patients who are still seeking aggressive treatment, who are not hospice appropriate, who have chronic conditions and need symptom management. We are set to start our inpatient palliative care team next month and are still learning about the concept. Our palliative care team will be an extension of our hospice with different team members including a doc, Rn, MSW, Chaplain and volunteers initially and as we grow will add NPs.

marachne · Sep 22, 2008

A lot of what I see the role of palliative care teams is a combination of symptom management and exploration of goals and values.

Because with palliative care, every option is still on the table, and, in general palliative care teams both have highly developed communication skills, more time than your typical hospitalist or clinician, and often a higher comfort with discussing prognosis openly, honestly, and in terms understood by lay persons, we can help people figure out what is really important to them -- is spending as long as possible alive important?* Then we'll talk about what the options are and the consequences of the choices. Wanting to get to that daughter's wedding on the other side of the continent? We'll work on that.

The best part of my palliative care fellowship was learning how to have discussions that elicit from people what really matters, what kinds of things they want to make sure they have gotten done, where they draw the line, etc. Palliative care teams often will be the ones going to bat for a patient to get that plexus block, or bisphosphonate infusion to prevent cord compression. They will help families talk with each other as well as to other providers. It is an on-going process as a person is on their journey.

The MD in charge of palliative care service I did a rotation with described his clients not as the patients, but the staff -- he saw his job was to support the MDs, RNs, Therapists, etc in doing their job the best they could (including helping them recognize when it was time to change approaches, and helping them through those hard decisions). They also attended every withdrawal of life support that happened (as well as most , if not all family conferences about withdrawal of life support).

*working in the VA, more than once I came accross people who wanted to stay alive b/c that was the only way certain kinds of income -- such as a VA pension -- would continue to flow. If someone was worried about providing for those left behind, this can be an issue. On the flip side, I've seen families who want everything possible done for the same reason, even if the patient did not (or couldn't speak for themselves).