Hospice care and palliative care — when to use them

Hospice — a word that is synonymous with “end of life” care. Palliative — a little more confusing and often confused with end of life. The two are very different therapies but palliative care is an offshoot of hospice.

Hospice is a service for patients who are terminally ill and have decided not to take any more medication that might “cure” them (i.e. chemotherapy for a cancer patient). The focus becomes relief from pain and symptoms and not a cure. There are some who say that going into hospice means you are giving up or that you will no longer receive the medical care you need. That is not true; you have chosen to focus on your quality of life not the quantity and the medication used is to do just that.

A hospice team usually includes a doctor, nurse, social worker and chaplain (if you wish). They work together to meet the patients physical, emotional and spiritual needs. This team also cares for the family who can be against the choice to, in their eyes, “give up.” There is counseling, hugs and support from a good hospice team. My Mother’s team was unbelievable and supported and counseled our entire family through the last three days of her life.

To qualify for hospice your doctor must state that the patient’s death is expected in six months or less. If a patient chooses hospice then changes his or her mind, it isn’t an issue. The patient simply goes back into the curative therapy with their doctor.

You also can change your mind again and be readmitted. There is no presuure; it is about what you, the patient, want.

Palliative (pronounced pal-lee-uh-tiv) care is specialized medical care for people with serious illness. This type of care is focused on providing relief from the pain, symptoms and stress of a serious illness for both the patient and family.

Again, it is a team of specially trained doctors, nurses and other specialists who work in partnership with the patient’s other doctors to provide an extra layer of support. It can be used at any age and at any stage in a serious illness. The services are offered in tandem with the curative treatment. A good example of palliative care use is in Parkinsons or Multiple Sclerosis when there are flare ups.

Both hospice and palliative care are paid for by most insurance companies including Medicare and Medicaid. Both are offered in your home, nursing homes, assisted living centers, hospitals and provide respite care when the caretaker family needs a break.

What these two services offer us are choices in treatment for serious illnesses. We each have our own journey and while none of us hope it comes to either of these services, we can make informed decisions for us or our loved ones knowing that they exist. No matter how strong you are physically and emotionally, watching a loved one suffer is often intolerable. There are teams out there to support and comfort. Use them if you need them.

Frances Reaves, Esq., a graduate of the University of Miami Law School, spent 10 years as a litigator/lobbyist. Today, she Is an accomplished business woman who, when her parents could no longer take care of themselves, learned the ins and outs of senior care (or the lack thereof). She founded Parent Your Parents to assist seniors and their children through the myriad pitfalls and options of “senior care” in the 21st Century. If you have any questions or comments contact Frances at hfrancesr@parentyourparents.com.


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