What is Hospice and Palliative Care and How to Tell the Difference

© 2011 Guiomar Göransson, RN, CHPN

It’s surprising how often nurses who work in either home hospice or a free standing hospice, know so little about palliative care. The CHPN© exam is a certification for both hospice and palliative care, but most people (including nurses) just hear the hospice part.

The line between hospice and palliative care is sometimes blurred and a patient may be receiving palliative care without hospice, however, a hospice patient is usually almost always receiving palliative care.

PALLIATIVE CARE
The word ‘palliative’ originates from the Latin pallium, a cloak. In palliative care, symptoms are ‘cloaked’ with medication and therapies whose primary aim is to promote comfort.

Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification, assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

Palliative care:

• provides relief from pain and other distressing symptoms;
• is applicable early in the course of illness, in combination with other therapies that are intended to be life sustaining, such as chemotherapy or radiation therapy.
• regards dying as a normal process;
• does not artificially hasten or postpone death;
• at its best, with skillful practitioneres, provides psychological and spiritual aspects of patient care;
• offers a support system to help patients live as they wish, until death;
• offers a support system to help the family cope during the patient's illness and in their own bereavement issues and counseling, if needed;
• enhances quality of life, and at times, positively influences the course of illness;

HOSPICE CARE
Hospice care is intended for people who are nearing the end of life. Specifically, six months or less. Hospice care services are provided by a team of health care professionals who are supposed to be comfort-care specialists for a terminally ill person by reducing pain and addressing physical, psychological, social and spiritual needs (not all are!). Unlike other health care, however, the focus of hospice care isn't to cure or treat the underlying disease. The goal of hospice care is to provide the highest quality of life possible for whatever time the hospice patient has..

Hospice care is for terminally ill patients who are expected to die in six months or less. This doesn't mean that hospice care will be provided only for six months, however. Hospice care can be provided as long as the person's doctor and hospice care team certify that the condition, left to its natural course, will result in death ordinarily in 6 months or less. Many people who receive hospice care have cancer, while others may have varied conditions, such as CAD, Alzheimer's or COPD to name a few. Enrolling in hospice care early may help a patient and/or families develop a strong relationship with the hospice staff, who may be able to help with preparation for end-of-life needs.

The growth of palliative care and the development of palliative medicine consultation services are major end-of-life trends with huge implications for America’s hospice industry.

Excerpted from How I Passed the CHPN® Exam the First Time! 2nd Edition.