Erica Schockett, MD, is a hospice and palliative medicine specialist at Inova.
There are a lot of myths and misunderstandings about what hospice and palliative care really are and when they should be considered. In this article, I’ll break down the myths, explain the differences, and show how these services can improve quality of life for patients and families.
What Are Hospice and Palliative Care, and How Are They Different?
Palliative care and hospice care are both specialized forms of medical care for people who are coping with serious illness. They both focus on managing symptoms effectively and optimizing quality of life, based on what matters most to patients and families. Whether a person has a curable illness, a long-term chronic illness, or even a terminal illness, these specialty services are meant to help people live their lives as well as possible.
But there are notable differences between palliative and hospice care. Palliative care is designed to improve quality of life for patients facing serious illness by managing symptoms, reducing stress, and addressing emotional, social, and spiritual needs. Unlike hospice, palliative care can be offered at any stage of illness, and it doesn’t matter whether a person is receiving treatment or pursuing a cure. For example, if a person is receiving cancer therapies such as chemotherapy or radiation, they may also receive palliative care alongside those treatments to enhance comfort and support.
Hospice, on the other hand, provides comprehensive care for patients who are in the final stages of a serious illness, when doctors believe the patient has six months or less of life remaining. At this stage, comfort becomes the priority. Hospice care is provided by an interdisciplinary team — including physicians, nurses, social workers, chaplains, and other specialists — who support the patient and their loved ones wherever that patient calls home.
The interdisciplinary team model is one of the distinguishing features of hospice care. It helps address the physical, social, emotional and spiritual or existential aspects of care. The team also focuses on providing education and guidance, so patients and families feel more prepared for the kinds of changes that happen with a serious illness and in their hospice care journey.
Busting the Top Palliative Care and Hospice Myths
Myth 1: Palliative care is for those who are dying
Not at all. Palliative care is for people dealing with serious illness and its symptoms and effects on their function and quality of life, but it’s just as appropriate for someone with a curable illness as it is for someone who is nearing the end of life. Palliative care can be helpful regardless of life expectancy.
Myth 2: Hospice is only for people who are close to death
Neither palliative care nor hospice care means that a person is dying right now. All people deserve support and relief from suffering when their lives are touched by serious illness. In fact, an earlier referral for hospice care can help people get the most out of hospice care and maximize their quality of life.
Myth 3: When people start hospice care, they must stop seeing their other doctors
Myth 4: A person “goes to hospice”
Hospice is not a place. It’s a specialty service. While receiving hospice care, patients can continue to live their lives in private, they can leave the house, they can socialize. Hospice is there to support that process.
Myth 5: Hospice care ends with the patient’s death
The hospice team helps patients and families cope with grief before death as well as after the patient’s death. Bereavement services can continue for up to 13 months after death, supporting families through the first year and through the anniversary of the loss.
Myth 6: Hospice and palliative care specialists only focus on pain management
Hospice and palliative care specialists do so much more than manage pain. They are experts in relieving distress, for patients and families alike. They provide excellent symptom management to relieve the physical burden, and they provide education and anticipatory guidance, so caregivers understand how to best care for their loved one as they move through this journey. They’re experts in serious illness communication, helping patients and families plan for the future and navigate the present.
Myth 7: Patients need to wait until a provider offers them palliative care
Anyone with a serious illness who has unmet symptom management needs or doesn’t feel they’re getting enough support with advance care planning or medical decision-making can ask for a palliative consult. While it’s a personal decision, I also encourage anyone dealing with a serious illness to gain an understanding about what palliative and hospice care can offer.
Care Focused on What Matters Most
The most difficult thing, emotionally speaking, may be deciding when is the right time to enroll in hospice care. There are so many advanced therapeutics available in healthcare and individuals may want to pursue every treatment option available, leaving no stone unturned in pursuit of a cure.
It’s becoming even more important for patients and families to engage with their providers and have frank conversations about the potential risks and benefits of disease-modifying treatments in the end stages of an illness. Patients and families can benefit from learning more about hospice earlier on, because it’s a dignity-based care approach that can have positive quality of life effects. Hospice benefits the people who receive it, shifting the care philosophy to something focused on enhancing quality of life at a time when it matters most.
Learn more about hospice services and palliative care at Inova.
Feature image, stock.adobe.com
