By Laura S. Johnson / For The Herald
As a palliative medicine physician, I meet people who don’t know what palliative medicine is about every day. They often assume that palliative care is the same thing as hospice care (spoiler alert, it’s not). And while the two specialties are complementary, it’s important that patients and families understand how and why they serve different purposes in a patient’s health care journey.
Without this understanding, patients and families could miss out on the important benefits these programs offer.
The holidays can be a tough time for families with loved ones facing major medical issues, such as those in hospice and palliative care. It’s a good time to clarify the similarities and differences between the two types of care.
First, let’s cover the similarities. Both specialties:
• Offer relief from the symptoms and stress of a serious illness.
• Address patients’ and their families’ emotional, social and spiritual needs.
• Are provided by interdisciplinary teams.
• Provide opportunities for clinicians to spend extended time with patients and their families, getting to know them as people, not just patients.
• Are typically covered by Medicare and most other medical insurance plans.
But palliative care and hospice care differ in several important ways: who’s eligible (eligibility criteria), how care is delivered (care model) and what the goals of care are.
Who is eligible? Palliative care is specialized medical care for people living with a serious illness in any stage. There are no set criteria that qualify a patient for palliative care: It’s available to any patient experiencing a serious illness at any point in their treatment journey.
In contrast, hospice is a care system for patients with an estimated life expectancy of six months or less.
How is care delivered? The palliative medicine team provides care in conjunction with other therapies that are intended to prolong life. Like other medical specialties, palliative care is usually provided in outpatient clinics or in the hospital, if the patient is hospitalized. Some palliative care programs even offer home visits.
In a palliative consultation, the clinician provides two key things:
• Expert and holistic management of distressing symptoms related to a serious illness.
• Skilled and in-depth communication to establish care priorities that align with the patient’s own values and preferences.
The palliative care team works to make sure that everyone — the patient, whoever is supporting the patient, and the patient’s health care team — is on the same page.
Hospice is a comprehensive system of care providing comfort-focused care to patients wherever they live. Hospice services include medical and nursing care, spiritual care and social work support. Hospice also provides medical equipment, medications and phone support 24/7.
In a small number of cases when symptoms can’t be managed at home, hospice care can be provided in a free-standing hospice care center, like EvergreenHealth’s Hospice Care Center, or a hospital.
What are the goals of care? In palliative care, the goal is to relieve suffering and provide the best possible quality of life for patients and their families. Palliative care is often provided in conjunction with treatments aimed at extending the patient’s life. It is also frequently provided when no further life-prolonging treatments are available, but a patient isn’t yet medically eligible for hospice care or simply doesn’t wish to enroll in a hospice program.
Patients elect hospice care at the point when they’re ready to forego attempts at prolonging life — including hospitalization — in favor of comfort-focused care.
So, what are the big takeaways? Palliative care offers symptom relief and a stop along a patient’s treatment journey to regroup, think about what matters most and plan for what’s next. Hospice care is comfort-focused care that is typically provided in a patient’s residence.
If you or a loved one is considering palliative care or hospice, ask your health care provider to consider making a referral to the program that fits your situation best. You can also contact palliative care and hospice programs in your area directly to learn more about how these programs can help you or your loved one.
Dr. Laura S. Johnson is medical director of EvergreenHealth Palliative Medicine in Kirkland.
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