Palliative & Hospice Care

What is Palliative Care?

So, what exactly is palliative care? That’s a great question! Surveys and studies show that even some physicians, doctors and other caregivers do not fully comprehend its scope or breadth; many lay persons and medical professionals alike understand it to be symptom control and comfort management — reducing pain, helping with breathing difficulty, reducing bed sores etc.,  — during a patients last days. That is not correct! Palliative care is not hospice care.

The verb ‘palliate’ means to “make (something — usually a disease or its symptoms) less severe or unpleasant.”  A search for synonyms yields the following:  alleviate, ease, relieve, soothe, take the edge off, assuage, moderate, temper, diminish, decrease, blunt, deaden.

The organization Get Palliative Care provides the following definition:

Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.

Palliative care is provided by a specially-trained team of doctors, nurses, social workers and other specialists who work together with a patient’s doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

 

There are two important things to understand:  

(a) the goal of palliative care is to improve the quality of life for both the patient with a serious illness and his or her family; and

(b) it is useful and helpful at any age and at any stage of the serious or chronic illness  starting with the initial diagnosis and throughout the trajectory of treatment. 

Palliative Care focuses on four areas that impact the lives of both patient and family: Physical, Psychological, Social and Emotional.  The essence of palliative care lies in recognizing  the symptoms related to each of these, and managing them effectively through an intervention of some kind.  Critical to success are timely and proper communication with patients and families, detecting these symptoms — whether they are physical, psychological, social, or existential, and then following through with the appropriate strategies to alleviate these symptoms.

Palliative care applies equally to any serious disease or chronic illness. Proper administration of palliative care takes a team of qualified and trained professionals.

If you or someone you know is facing a chronic illness,  consider palliative care.  It will improve quality of life.  Reach out to the care providers and ask about it’s availability concurrent with the ongoing treatment plan.

As reported in the Mercury Newsa growing number of California hospitals — especially in the Bay Area — are offering palliative care for patients living with serious illnesses.  Consult with your care team to determine the best option for you. Palliative care is most effective when it is properly integrated into the overall plan of care.

Two hospitals that offer both inpatient and outpatient Palliative Care consultation and treatment are:

Stanford Hospitals and Clinics  “Palliative care focuses on improving the quality of life for patients and their families through the management of symptoms, pain and stress brought on by a serious illness.”

Kaiser Permanente “specialized care for people with serious illness and is provided by a doctor, nurse, social worker, and chaplain, and in coordination with your primary care physician”

Other Bay Area facilities offering palliative care  include UC San Francisco and Sutter Health.

 

Hospice Care

Hospice Care is not the same as Palliative Care. It provides terminally-ill patients and their families quality and compassionate care and the support they would need at the end of life.  The National Hospice and Palliative Care Organization  describes it this way:

“Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice care involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes. Support is provided to the patient’s loved ones as well. At the center of hospice and palliative care is the belief that each of us has the right to die pain-free and with dignity, and that our families will receive the necessary support to allow us to do so.”

Here are some FAQs – Frequently Asked Questions – from the National Hospice and Palliative Care Organization:

What is hospice care?   Hospice focuses on caring, not curing and in most cases care is provided in the patient’s home. Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities.  Hospice services are available to patients of any age, religion, race, or illness. Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.

How does hospice care work? Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on-call 24 hours a day, seven days a week.

The hospice team develops a care plan that meets each patient’s individual needs for pain management and symptom control. The team usually consists of:

  • The patient’ s personal physician;
  • Hospice physician (or medical director);
  • Nurses;
  • Home health aides;
  • Social workers;
  • Clergy or other counselors
  • Trained volunteers; and
  • Speech, physical, and occupational therapists, if needed.

What services are provided? Among its major responsibilities, the interdisciplinary hospice team:

  • Manages the patient’s pain and symptoms;
  • Assists the patient with the emotional and psychosocial and spiritual aspects of dying;
  • Provides needed drugs, medical supplies, and equipment;
  • Coaches the family on how to care for the patient;
  • Delivers special services like speech and physical therapy when needed;
  • Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time; and
  • Provides bereavement care and counseling to surviving family and friends.

There are a number of hospice care providers in the Bay Area.  We provide links to three of them below. However, everyone is encouraged to carry out their own investigation to determine which organization best suits their needs.

Hospice of the Valley At Hospice of the Valley, our goal is to provide expert care that enhances your quality of life wherever you call home, whether it is a private residence, an assisted living facility, nursing home or hospital.

Pathways Home Health and Hospice “Pathways family of services has been bringing healthcare to people, wherever they live, for 38 years.  With kindness and dignity we assist the elderly, heal the sick and comfort the dying.Pathways is a pioneer in care at home and has a sterling reputation for hospice, home health and private duty care.”

Vitas Hospice   “VITAS Healthcare provides hospice and palliative care for adult and pediatric patients with life-limiting illnesses in the Northern California area. We work with patients and families to provide comfort and preserve dignity in the face of terminal illness.”