Palliative Care v. Hospice Care
Courtney Carter
/ Categories: WELLNESS, 2024

Palliative Care v. Hospice Care

The Differences and Benefits

When facing a serious illness, understanding your care options can make a world of difference. While the terms palliative care and hospice are often used interchangeably, they’re distinctly different types of care, each focusing on a different step in an individual’s care and end-of-life journey.

Simply put, palliative care focuses on maintaining the highest quality of life while managing treatment and other needs while hospice care focuses on the period closest to death.

Here’s a deeper dive into how each supports individuals and families facing serious illness and end of life.

 

What is Palliative Care

Palliative care is specialized medical care for people living with a serious illness, such as cancer, dementia, COPD, and heart failure. Often called supportive care, palliative care focuses improving quality of life and helping with symptoms.

Because people receiving palliative care may receive medical care for their symptoms along with treatment intended to cure their illness, palliative care aims to help patients understand their choices for medical treatment.

In addition to addressing medical needs, palliative care focuses on the emotional, spiritual, and social needs of the patient and their family. This all-encompassing care is typically provided by a team of specially trained doctors, nurses and other specialists who work to connect patients and families with the resources they need and minimize the disruptions their illness or treatments may cause in daily life.  

Key aspects of palliative care include:

  • Pain and symptom management

  • Help with setting care priorities and preferences

  • Support for patients and loved ones throughout the illness journey

  • Assistance with advance care planning

Palliative care can be provided in a variety of settings, including hospitals, long-term care facilities, and at home.

The benefits of palliative care have been well-researched and documented. Beyond empowering individuals to control their care and quality of life, palliative care is associated with:

 

What is Hospice Care

Hospice care is specialized care for those in the last phase of a terminal illness when curative measures are no longer pursued; typically for those with a life expectancy of six months or less. 

While individuals in hospice do not receive curative treatments for their illness(es), they can get treatment that enhances quality of life. This may include medication for high blood pressure, anxiety, and pain and even special services like speech or physical therapy.

Key aspects of hospice care include:

  • Round-the-clock access to care

  • Pain and symptom relief

  • Emotional and spiritual support for patients and families

  • Bereavement services for loved ones

It’s important to note that if a patient’s condition improves or they decide they wish to resume curative care, they may leave and return to hospice care later.

Hospice care can be provided at home, in hospice centers, or other facilities.

The benefits of hospice care include:

  • Relief suffering

  • Help with medical and non-medical needs

  • Promotion of dignity

  • Support for family and caregivers

  • Closure for patients and families

 

By understanding palliative and hospice care, you and your loved ones can make informed decisions that are in line with your goals, values, and preferences.

For tips on talking to loved ones about serious illness and care—theirs or your own—click here. Whatever you decide to do, be sure to relay any wishes and decisions to the appropriate healthcare provider.

While these conversations may be difficult, it’s important to keep the end goal in mind: preserving personal comfort, dignity, and making the most of your time.

 

Allen Hutcheson, MD, is a family medicine physician and palliative care specialist at Southwestern Vermont Medical Center. 

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How to Maintain a Healthy Immune System

There are so many things that we have little control over. We can't control what genes we get, how old we are, or what viruses are circulating in our environment, but there is a lot we can do to prevent illness. Remarkably, many of the same habits that protect you from diseases like diabetes, cancer, and heart disease also help your immune system fight infections.

Most viruses can't hurt you until they get inside your body. So, we can help our immune system if we avoid viruses and cut off the ways they travel. Viruses can spread through the air, but not usually for very far. Keep your distance—at least 6 feet—from others, and be a good neighbor by wearing a mask in all public areas.

Viruses that cause the most common illnesses—respiratory infections, including the common cold, flu, and the new COVID-19—travel into the body through your mouth, nose, and eyes and make their way to the areas they infect, like the lungs. The best way to break this chain is to clean your hands frequently, and don't touch your face with hands that have touched anything else. In addition, you can reduce the number of viruses in your environment by cleaning frequently touched objects with a bleach- or alcohol-based cleaner.

Vaccinations are your next line of defense. Immunizations, like the flu shot, introduce a small and harmless part of a virus or bacteria. The vaccine gives your immune system an opportunity to make antibodies against the virus. A vaccinated immune system responds more quickly and effectively when illnesses are introduced. What's more, when we all get vaccinated, we decrease the likelihood that anyone will get sick. If you are unsure about whether you or your children are up to date on their vaccinations, call your primary care provider’s office.

Your third line of defense is living a healthy lifestyle. It is clear that the same things that help the rest of our bodies function also improve the strength of our immune response. Likewise, things that hinder our bodies' ability to function compromise the immune system.

Regular exercise might be the most powerful way to maintain a healthy immune system. By increasing heart rate and blood flow, we allow the cells and substances of the immune system to move through the body freely and do their job efficiently. Similarly, things that slow the movement of cells and substances, like smoking or drinking alcohol in excess, may decrease the body’s ability to function and decreases the immune response, as well.

Getting adequate sleep may also positively affect the immune response. Chronic sleep deprivation has been shown to decrease the beneficial boost in immunity from vaccinations.

Our emotional state, too—whether we are stressed, lonely, or depressed, for instance—affects our immune response so much that a relatively new specialty called psychoneuroimmunology now studies the connection. One pioneering study, conducted in the early 1980s, found that college students operating within a stressful 3-day exam period had fewer of the cells that fight tumors and viral infections. In simple terms, the students almost stopped producing immunity boosters and infection fighters.

Finally, physicians have concluded that eating a mostly plant-based diet—including fruits, vegetables, beans, nuts, whole grains, and lean protein—supports overall health and may also support immunity. Nutritious foods include important vitamins that the immune system needs to function, such as beta carotene, vitamin C, vitamin D, and zinc. Note, however, that supplements that claim to improve immune function have not yet been shown to do so to the extent necessary to protect against infection and disease. It is better to eat whole foods that are rich in vitamins rather than take supplements.

Always consult with your provider before making changes to your exercise plan or trying a new supplement and if you have any medical concerns. Physicians and the other professionals working in their offices also provide help for developing a plan for a healthier life. Call your primary care office or 802-447-5007 to find a primary care provider.

Healthy habits, like those that protect your body from disease and infection, are not always easy to adopt or maintain. Perhaps knowing just how important they are to maintaining a healthy immune response will provide the extra motivation necessary to make them a priority.

Kim Fodor, MD, is an internal medicine physician at SVMC Internal Medicine.

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