Q. A few months ago, I needed to make some difficult medical decisions for my mother as her health declined. It was disheartening and I’ve carried some guilt because of it. My husband and I don’t want our children to be burdened with similar decisions. We are meeting with our lawyer to revisit our will and trust so that our children have a road map to follow. That being said, I’m having a difficult time grasping the difference between hospice care and palliative care. Cancer runs in our family; my mother died from breast cancer. Although she received hospice care in her final two weeks, I wish I would have known more about it and/or how palliative care might have been utilized. Can you provide me with more information about hospice care and palliative care?
A. I am so sorry to hear about your mother’s battle with cancer. I empathize with your struggle with guilt. It’s never easy making medical decisions on behalf of our loved ones.
Briefly, hospice care is comfort care without curative treatment. It’s for individuals facing a terminal illness with a prognosis of six months or less. It is covered by Medicare, Medicaid, and private insurance.
Palliative care is comfort care provided alongside curative treatment. It’s based on the care needs of the patient, not the diagnosis. Anyone can receive palliative care regardless of their diagnosis. Palliative care does not require a terminal diagnosis. Palliative care costs vary and may or may not be covered by certain insurances.
Both hospice care and palliative care focus on quality of life and helping the patient manage pain and symptoms. Both can be provided in the home, hospital, senior living residences, or specialized clinics. Both are also comprised of an interdisciplinary team that addresses the physical, emotional, and spiritual needs of both the patient and the family.
Say you’re diagnosed with breast cancer. You immediately begin curative treatment. Here is where you may benefit from palliative care. Palliative doctors and nurses can help alleviate the symptoms and side effects of chemotherapy and radiation, such as nausea, fatigue, and pain. A dietician might provide nutrition recommendations to help your body recover from cancer treatments. A social worker can connect you with support groups and help you navigate health insurance. A chaplain can offer words of encouragement as you undergo treatment. This additional care and support only help to improve your quality of life.
Should treatment become ineffective and you’re given six months or less to live, palliative care can help you transition to hospice care. Again, the goal of hospice care is to keep you as comfortable as possible when curative treatment is no longer an option. Your hospice care team might start by visiting once a week to help with symptom management. As your care needs progress, hospice care also increases. They may help with activities of daily living, such as assisting you in the shower. They will monitor your pain levels and adjust medications as needed. They may offer counseling for you or your family to help cope. They can also offer respite to your family so that they can run errands or rest.
I encourage you to discuss hospice care and palliative care with your primary care physician. Your doctor can help guide you in making informed decisions and update your medical records to reflect your care preferences.
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