When faced with a life-threatening illness, patients and their families may look to palliative care or hospice services as part of the patients' medical management. Palliative and hospice care share a medical philosophy. Both types of care focus on ameliorating or at least maintaining the patient's quality of life, through means such as pain reduction, spiritual advice and counseling to help make the illness more bearable for both the patient and the family. In hospice, patients receive only palliative care, but any patient with a life-threatening illness may request palliative care.
Focus of Treatment
Palliative care means keeping a patient as comfortable as possible during an illness. Palliative care may come into play at any point after a physician diagnoses a life-threatening condition. When patients find the side effects of treatment too much to bear and physicians have determined that the disease is incurable, palliative care may become the only focus of medical care. At this time, some patients opt for hospice services, during which health care workers give only palliative care. In the last months of life, hospice workers including physicians, nurses, clergy and social workers, concentrate on keeping the patient comfortable.
Goals
Unlike hospice services, palliative care does not preclude the use of treatment directed at curing a patient's disease. Palliative care, whether given in tandem with treatment directed at a cure or in a hospice situation, aims to lessen patient suffering. Palliative care workers focus on helping the patient to breathe more comfortably through the use of relaxation techniques or medication. They provide psychotherapy and medications to deal with the common issue of depression during the course of a difficult illness. Through diet interventions and the provision of stimulating activity during the day, health care workers attempt to reduce patients' fatigue, insomnia and digestive problems. Finally, an objective is to lessen the pain the patient feels as much as possible.
Location of Services
Hospitals are equipped to provide palliative care, but some hospitals employ inpatient, or in-hospital, palliative care consultation services to hep care for patients. Some patients who are not admitted to the hospital receive palliative care from outpatient, or out-of-hospital, clinics. Home visit programs also exist for those who cannot or prefer not to travel to outpatient clinics. Hospice care can be delivered in acute hospice units located in some hospitals, but many patients prefer home hospice, which consists of a few hours of professional care per day in the patient's home. An in-between option is volunteer-run hospice houses, where patients benefit from a home-like atmosphere as well as the care of the staff and volunteers.
Cost Considerations
Medicare, which is a government program designed to help the elderly with medical bills, and Medicaid, a government program that helps those otherwise unable to afford medical care, both cover hospice care. Most private insurance companies do as well. However, Medicare and Medicaid do not cover the cost of palliative care when it is provided in a setting other than hospice. Only some private health insurance plans cover palliative care.
Benefits
Benefits of palliative and hospice care go beyond relief from pain. This type of care can ameliorate a patient's quality of life by providing an understanding of the process of death and dying, so that the patients and their families can ask questions and make arrangements for the patient's funeral in a less stressful context. Additionally, patients' quality of life can rise with the activities, psychotherapies and clergy services that palliative care offers.
References
- Information on Palliative Care
- "The Behavioral Sciences and Health Care"; O. Sahler and J. Carr; 2007
Member Comments