Last week I was caring for an 84 year-old gentleman who had been battling
colon cancer at home. His condition
worsened and he ended up in our ICU after having major abdominal surgery. He had never had palliative care, which would
have been a benefit since, at his age, he was unlikely to recover to his
previous level of function. Now that he
was even more deconditioned, it was appropriate to discuss palliative care for
him. I found this article, written by an
Emergency Physician in California which helps clarify supportive care at the
end of life.
Clearing palliative care confusion
Posted: Friday, February 5, 2016 6:40 pm
By Terry Hollenbeck MD
There seems to be some
confusion when it comes to understanding the difference between palliative care
and hospice. They are both distinctive medical disciplines and often work
together.
Hospice care comes into
play when a patient has a terminal illness and all treatment options have been
exhausted. It is really for those who have been determined to be in their last
six months of life. The goal of hospice care is not to cure the underlying disease
but to support the quality of life. Hospice care maximizes comfort for
terminally ill patients while also addressing physical, social and spiritual
needs.
Hospice care is most
commonly provided at a patient's home, with a family member typically serving
as the primary caregiver, but, it is often available in facilities. The hospice
care team is usually available 24 hours a day, seven days a week.
Palliative care is medical
care based on the goal to relieve pain and suffering, reduce symptoms, ease
stress, and mainly to improve a patient's quality of life during a serious
illness and is not limited to end of life issues. People who are actively being
treated for a disease can receive palliative care at any stage of their illness
whereas hospice is thought of as end of life care.
This is an important
distinction because many people think of palliative care as end of life care.
The palliative care team works closely with the patient's primary treating
physician in caring for the patient. While the patient's treating physicians
may be trying to prolong life, palliative care's goal is to maximize quality
of life.
Identifying and managing
pain is one of the main priorities of any palliative care program. Palliative
care also seeks to improve many other troublesome sources of physical
discomfort such as shortness of breath, constipation, and insomnia.
