Palliative medicine, hospice differ but strive for same goal

As care evolves for those experiencing chronic conditions, many patients ask: What’s the difference between palliative medicine and hospice care?

While palliative medicine and hospice share the same philosophy of focusing on a patient’s comfort through an emphasis on quality of life, they are different in how and when this service is provided to the patient and their family.

Palliative medicine is the care of seriously ill patients who have a life expectancy of less than two years (generally speaking). Patients who receive palliative care often have life-threatening, life-limiting illness but not necessarily terminal illness. Some examples include severe COPD (chronic obstructive pulmonary disease), CHF (congestive heart failure) and dementia. Patients with serious illnesses such as these are burdened by symptoms such as pain, shortness of breath, anxiety, digestive issues and insomnia.

Palliative medicine specialists provide symptom management through medications, therapy, counseling, spiritual support and other means depending on the patient and family situation.

For example, a patient suffering with pain may benefit from pain medications but also aquatic therapy, massage, spiritual counseling and social support. Palliative medicine can provide this level of comfort care for chronically ill patients for months to years improving their overall quality of life for both themselves and their caregivers.

Hospice care is delivered as an insurance benefit to those with terminal illness and a prognosis of 6 months or less life expectancy. This is defined by two physicians who evaluate the patient and determine that death is likely if their disease follows its natural trajectory.

Like palliative medicine, hospice provides aggressive end-of-life symptom management, nursing and aide services, social support, chaplaincy and bereavement.

Palliative medicine specialists are integral in expediting referrals for hospice when the criteria are met for admission, allowing the patients and families the most possible time for these important end-of-life services. Palliative medicine physicians and hospice directors can assist in ensuring comfort as the patients are transitioned to hospice care.

Palliative medicine and hospice together provide patients and their families a continuum of care surrounding the end of life. They strive to care for patients physically, mentally and spiritually as they face the dying process.

Family support and bereavement remain a very important piece of the care provided. While differences exist between the two specialties, the goals of care remain the same- interdisciplinary, holistic care that emphasizes living and focuses on providing comfort to those suffering and their families.

Giorgini is a hospitalist and medical director of palliative medicine at Evangelical Community Hospital in Lewisburg.

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