A hundred years ago, the average life expectancy in the United States was just under 50 years. Today it’s nearly 80 years – a true testament to the benefits of modern medical advances. The development of highly effective treatments and technologies significantly extended Americans lives.
However, these technological treatments can also affect quality of life, and not always for the better. Many treatments and procedures help prolong life, but can’t spare patients from the physical pain, emotional stress and even disability caused by life-threatening and serious illnesses such as cancer, stroke and congestive heart failure.
Today, more and more patients – and their families – are turning to palliative and hospice care specialists to meet patients’ holistic needs.
The goals of palliative and hospice care are similar: to alleviate the patients’ physical pain, as well as help them and their loved ones cope with the cascading effects of serious illness. Depression. Spiritual crises. Shifting family roles and responsibilities.
The difference? Patients of any age and any stage of a serious illness can receive palliative care. This additional layer of specialized medical care is delivered by a palliative provider, who works with a patient’s attending doctor or specialist. The palliative doctor or nurse practitioner helps not only relieve a patient’s pain and symptoms, but helps the patient understand the disease and care options available.
Hospice care, on the other hand, focuses specifically on the needs of patients and families facing terminal illness. Hospice care is provided where the patient lives by an interdisciplinary team including doctors, nurses, certified nursing assistants, chaplains, trained volunteers and bereavement counselors. This team focuses on comfort and peace for the patient and family as they face end of life.
Despite the many benefits of both palliative care and hospice care, recent studies show that too many patients are referred to such care too late and that the full benefit of the care is not received.
Research shows that when palliative care is received early, it can extend a patient’s life by nearly a year, while reducing hospital readmissions. The same is true for hospice patients: One study found that on average, patients who received hospice care lived an average of 29 days longer than those who chose not to receive hospice care. Hospice patients are also hospitalized less often and receive fewer unwanted treatments than other terminally ill patients.
Patients can receive both palliative care and hospice care with a referral from their doctor. Families can also help their loved ones receive the holistic care they need by recognizing certain physical signs and other indications, such as:
- A decline in health, even after standard or aggressive treatments
- Doctors say there is nothing else they can do
- Treatments and/or disease symptoms are eroding the patient’s quality of life
- The patient is depressed and anxious
- The patient can no longer manage daily tasks or live alone, and must depend on family members and other loved ones
Once the decision to receive hospice or palliative care is made, a specialized team of health care professionals come together to meet the patient’s needs. The team works with the patient’s attending doctor to define care goals and a pain-and-symptom management plan.
Things to consider
Before deciding on a palliative or hospice provider, patients and families should compare each one’s capabilities and offerings. In most cases, patients receive hospice services where they live, allowing the patient to be in a familiar and comfortable setting.
Patients and families might also consider the provider’s track record, including accreditations and awards. CHAP (Community Health Accreditation Program) is an example of a third-party, not-for-profit accrediting organization that can serve as an indicator of attentive, effective caregiving.
Lastly, when a loved one has a serious illness, ask how palliative care could help that person feel better. If the disease progresses and curative treatments are no longer an option, consider requesting information for hospice care. By talking to your doctors, nurses and social workers, you can have an ongoing dialogue about the care options available to help you live each day to the fullest.
Dr. Victor Alvarez is medical director of Evercare Hospice & Palliative Care in Atlanta, and oversees all patient care at the hospice.