The principles of palliative care and hospice care have similar goals that may often come together in an effort of providing the best care for a patient. Palliative care is holistic care of an individual with a chronic life debilitating condition whereas hospice care is for those with a terminal condition who have been diagnosed with 6 months or less to live. Palliative care usually will begin prior to the hospice care and continues to be joined with hospice care. “It is important to note that the prognosis-based distinction between palliative care (eligibility based on need, no prognostic restriction) and hospice (eligibility based on a prognosis of living less than six months) is unique to the United States, whereas in other countries the terms palliative care and hospice are largely synonymous”(1) “The Institute of Medicine ([IOM], 2003) defined palliative care as the total active care of the body, mind, and spirit. The aim of palliative care is to prevent or lessen the severity of pain and other symptoms, and to achieve the best quality of life” (IOM, 2003, p.2) throughout the course of any life –threatening or life-limiting healthcare condition.” (2)
In providing palliative care to an individual the possibility of curing the illness still exists. The patient is made as comfortable as possible but has not been given a time frame for death. An “Interdisciplinary palliative care teams assess and treat symptoms, support decision making and help match treatments to informed patient and family goals, mobilize practical aid for patients and their family caregivers, identify community resources to ensure a safe and secure living environment, and promote collaborative, and seamless models of care across a range of care settings (i.e., hospital, home, and nursing home).”(1) Palliative care begins when an individual’s quality of life has decreased because of their disease process and the prognostic restriction is not available. With hospice care, the illness is terminal. The interdisciplinary team will also assess the patient but will not seek a cure for the condition. Their goal now is care and comfort with the emphasis being comfort. “Hospice is a movement that offers palliative care to terminally ill patients; this type of care eases pain and suffering and helps a patient die with dignity but does not attempt to cure illness. This care may take place at home or in the hospital.
Some larger communities have a separate facility devoted to hospice care.”(3) With hospice care the individual and family have accepted the imminence of death with a six month period and the care the patient will receive will be based on making sure the patient is comfortable at all times. The facilities that provide hospice care are successful because the dignity and comfort of individual and critically important to both the patient and their family. Hospice care gives support to not only the patient but also to the family during this difficult time. This process of beginning hospice care is often delayed by the patient and patient family because it is makes the phase of dying a reality. Hospice confirms that there is not a cure available for a loved one and makes death more of a reality. Hospice also makes this last phase of dying more acceptable, and provides the spiritual comfort for the patient and their family.
Hospice care is not just patient based care, it is family based care. In discussing palliative care versus hospice care we can ascertain that “palliative care may be appropriate for anyone with a chronic progressive disease when symptom management becomes a challenge.”, but hospice care is palliative care for the terminally ill. The difference in these two types of care and the phase of death an individual is currently experiencing meaning the prognosis of death. “Hospice care is appropriate when patients and their families decide to forgo curative therapies in order to focus on maximizing comfort and quality of life, when curative treatments are no longer beneficial, when the burdens of these treatments outweigh their benefits, or when patients are entering the last weeks or months of life”(1)
References
Bonebrake, D., Call, K., Culver, C., & Ward-Smith, P. (2010, June).
Clinically differentiating palliative care and hospice. Clinical Journal of Oncology Nursing, 14(3), 273+. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA231807936&v=2.1&u=lincclin_fccj&it=r&p=AONE&sw=w&asid=cb9b3d9659946c2bae4f99e7c40bd81c Kincaid, L., & Labell, L. (2011).
Death and Dying: Hospice . Human Growth and Development (Third Edition ed., ).
Jacksonville: Florida State College. Meier, D. (2011).
Increased access to palliative care and hospice services: opportunities to improve value in health care. The Milbank Quarterly, 89(3), 343-380.
doi:10.1111/j.1468-0009.2011.00632.x