For people living with serious and terminal illnesses, there are a number of care options available. However, there is a great deal of misunderstanding and misconceptions about what certain types of care entail, especially in the case of palliative and hospice care.
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What is the difference between palliative care and hospice care?
Palliative care is specialized, interdisciplinary care for people living with serious and life-limiting illnesses and aims to provide pain relief and support for stress and other debilitating symptoms of their illness.
Palliative care is often mistaken to be end of life care, which is the care and treatment people receive when they are living their last months or weeks of their life. Palliative care can be part of end of life care, but a person does not have to be at the final stages of a terminal illness to receive palliative care. It is available for people of any age, at any stage of a serious illness, and helps them to stay on track with family life and work commitments and to manage their condition.
Hospice care is for patients who know they will not recover from their illness. Hospice care is given to people who are nearing the end of their life. A lot of hospice care takes place at the patient’s home, but it can take place in care homes or in dedicated hospices themselves, either in in-patient departments or as a day patient.
Not all patients receive on-going hospice care, instead periodically using hospice facilities for respite care, which gives their carers a break from looking after them. Additionally, patients can choose to use hospice care only when an illness is deteriorating, and pause hospice care if their condition is stable.
Medicines and other treatments can be described as palliative if they relieve symptoms of an illness or injury but do not cure the problem. As such, palliative and hospice care does not seek to cure patients of their illness but instead to make life as easy to live as possible while they receive other, possibly curative treatments for their illness.
Both palliative and hospice care are holistic approaches to care in order to maintain a good quality of life for both people living with serious illnesses and their loved ones, such as friends and family. This means that a person’s physical, emotional, psychological, and social wellbeing are all taken into account.
What do palliative and hospice care include?
Palliative care can be given alongside other treatments for an illness, such as therapy and medicine, and can be given for a long period of time.
The World Health Organization describes palliative care as an approach that: regards dying as a normal process; integrates psychological and spiritual aspects of patient care; helps patients live as actively as possible until death and is possibly able to positively influence the patient’s illness; and supports family through their relative’s illness and the bereavement process.
Hospice care can include:
- Physiotherapy
- Occupational therapy
- Alternative therapies such as massage
- Rehabilitation
- Respite care
- Bereavement care
- Spiritual and psychological support
- Practical care concerning finances.
Who provides palliative care?
Palliative care can be given in hospitals, care homes, nursing homes, hospices, or at a patient’s home. It is given by a team of palliative care professionals that co-ordinate the care with patient needs. Some people choose to change how and where they receive their palliative care depending on the progression of their illness.
If their condition has improved, they may prefer not to stay in a care home, for instance, and move back to their own home to receive treatment. Conversely, those who wish to die at home may move out of hospice care to receive specialist palliative and end of life care.
There are specialist care teams that can provide palliative care with training in managing more complex illnesses and care issues. These teams can include palliative care doctors, nurse specialists, and counselors, as well as specialist healthcare providers from physiotherapists, occupational therapists, and speech and language therapists, to dieticians and social workers.
Hospice care is given by individual hospice centers, nursing and care homes, and hospitals.
Whoever provides these types of care, their aim is to help the patient to live their life to the best quality possible and to recognize a person’s need to feel in control, stay connected to friends, family, and the world outside of their illness, and to be seen as a person and not just a patient. It is a person-oriented type of care.
How do you receive hospice or palliative care?
Speaking to a healthcare professional about accessing palliative and hospice care is a good way to learn more about what is available. Family members or friends of a patient receiving care can also access care for themselves to help them as their loved one progresses through their illness.
It is important to note that both hospice and palliative care are given alongside curative treatments for some serious illnesses and do not replace these treatments. For instance, patients receiving chemotherapy for cancer are still entitled to receive palliative care.
Hospice care can be accessed by contacting hospices directly and by talking to healthcare professionals about available options. There are also hospice care databases listing both adult and children’s UK hospice care, with links to international care alliances.
Why palliative and hospice care are important
It is important to know what palliative and hospice care options are available both to the person living with a serious illness and their friends and family. By understanding what care can be given, patients can improve their quality of life while living with their illness, and their loved ones can also be supported through the process. Additionally, legal, practical, and cultural and spiritual arrangements can be made before a person passes so that they can be sure everything that is carried out is done so according to the patient’s wishes.
Further Reading
New initiative aims to set gold standards for palliative care training