Facilitating End-of-Life Discussions- Differentiating Palliative and Hospice Care

Facilitating End-of-Life Discussions- Differentiating Palliative and Hospice Care

Starting end-of-life conversations is nobody’s favorite activity, however, it is crucial thing to make sure that both patients and their families are well-informed and comforted. When it comes to talking to them about palliative and hospice care it is crucial to make sure they know the differences between the two. Palliative care involves improving the quality of life for patients who have serious diseases, including those with a poor anticipated outcome, by fighting pain, symptoms, and social issues. Whether as a supplement to curative therapies or as an approach that does not depend on the patient’s lifespan, its advantages remain the same. Symptomatic conditions like refractory cancer, pre-heart failure syndrome, COPD exacerbation, and end-stage renal failure are some of the indications for palliative care (Sheikh et al., 2022).

In contrast, hospice care is specially designed for patients suffering from a terminal illness, generally with an average of six months or less to live. Its focus is mainly on enhancing comfort and dignity either at a patient’s home or hospice facilities (Sheikh et al., 2022). Hospice care emphasizes symptomatic relief, emotional support, and spiritual care and discontinues unnecessary treatments that do not offer any meaningful therapeutic benefit.

When discussing palliative care, it’s imperative to discuss with the patient their ideals, values, and aims regarding their care and explain that palliative care isn’t mutually exclusive to the current treatments ongoing and being sought. At the same time, it focuses on managing symptoms and making life comfortable(Teoli & Kalish, 2020). The use of palliative care early on is most advantageous for patients with circumstances such as advanced cancer, heart failure, COPD, and dementia.

Usually initiating a conversation about hospice care takes place when curative treatments do not work anymore or are not desired, and the patient’s prediction does not bear a significant life. Markers, such as repeated hospitalizations, deteriorating functional status, and progressive symptoms despite optimal medical care could suggest this disease (Sheikh et al., 2022). Participation in timely conversations about hospice care gets patients and their relatives enthusiastic regarding the informed decision-making that conforms to their goals and principles and, therefore, guarantees a supportive and honourable exit.

References

Sheikh, M., Sekaran, S., Kochhar, H., Khan, A., Gupta, I., Mago, A., Maskey, U., & Marzban, S. (2022). Hospice vs palliative care: A comprehensive review for primary care physician. Journal of Family Medicine and Primary Care, 11(8), 4168. https://doi.org/10.4103/jfmpc.jfmpc_2262_21

Teoli, D., & Kalish, V. B. (2020). Palliative Care. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537113/

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End-of-life discussions are difficult to have. Patients and families may not know how to initiate these conversations so it is up to the health care provider to initiate. them If you were to have a discussion with the patient and family regarding both palliative and hospice care how would you include in your conversation the differences between the two?

Facilitating End-of-Life Discussions- Differentiating Palliative and Hospice Care

What chronic end-stage conditions might benefit most from palliative care? When might you have a discussion with the family about initiating hospice care?