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 Become a Mask Wearer

Long before COVID-19, online chat groups for people with pulmonary fibrosis (PF) were filled with posts about how uncomfortable it is to wear a mask in public: not physically uncomfortable, a fact that was barely mentioned, but psychologically uncomfortable. For people with this condition or the lung transplant used to cure it, catching a cold or the flu could be deadly. They need to wear masks in public to help protect themselves from getting ill.

The participants discussed how awkward it is riding the bus in a mask, going to the grocery store in a mask, or boarding a plane while wearing one. They were mostly self-conscious that others would think they were ill or weak. Many would rather suffer the risk of getting fatally sick than put a mask on in a department store.

Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. This—along with distancing and handwashing—are crucial parts of returning to a more normal way of life. Suddenly, we are all feeling the psychological discomfort PF patients have felt for many years.

People usually have an interest in blending in. And, just like doing anything out of the ordinary, wearing a mask for the first time definitely feels like putting yourself out there. If we want to return to a somewhat normal way of life, masks are crucially important, along with frequent, thorough handwashing and keeping a distance from others.

Here are a few tips for making the leap from being someone nervous about wearing a mask to being a person who wears one regularly.

Do it for others. We know that people can spread COVID-19 as many as a few days before they get sick. Even if you feel fine, you could have COVID-19 right now without knowing it. At the same time, masks are far better at keeping sick people from spreading germs than they are at keeping people from getting sick. So wearing a mask isn't a sign of weakness; it's a sign of altruism. It's like saying, "I am not certain that I am not sick, so I want to pay those around me the consideration of limiting the likelihood I will infect them." Think of it as a badge of kindness.

Get a mask that fits. We know that masks are not completely comfortable physically. Getting the right fit makes a big difference in their "wearability." Cloth masks are readily available online and from local groups. The Green Mountain Mask Makers have excellent information and resources. If you can, purchase a few types in a few sizes to see which you like best. Buy enough of that type to allow washing between trips out in public.

Get a mask that you like. Once you have found a mask source and as long as you have a choice, pick one that you like. You can choose colors that match your wardrobe or that represent your interests, like camouflage. There are even masks that look like fashionable scarves when they hang around your neck. The sooner we start thinking of masks as part of our outfits, as essential and unremarkable as shoes or a belt, the healthier we will all be.

Try to quit caring about what others think. This one is hard. But one wise PF patient wrote, "I just don't give a darn!" Essentially, he shared that if people want to judge him for wearing a mask, so be it. Their opinions don't have a single thing to do with him. Many in the chat group applauded his confidence and vowed to adopt his attitude.

If we all do our best, soon the cultural scale will tip. Wearing a mask or not wearing one will cease to be a political statement. It will be normal. And thankfully, if wearing a mask in public, handwashing and sanitizing, and keeping our distance are all normal, going out into public again can be safe and normal too.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center.

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