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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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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