Palliative Care, Hospice Care

Palliative Care, Hospice Care

You love your parent, but love does not make these decisions easy.

What are the differences between hospice care and palliative care? Any caregiver who sees the quality of life ebbing away in their parent, child or whomever they are caring for, begins to think about comfort.  Comfort is about being pain-free so that one can sleep, eat, and perform necessary bodily functions.  Comfort is what both hospice and palliative care provide.

Comfort is pretty hardcore basic.  But at the end of a long illness, or as one is approaching an involved cancer treatment regime—comfort is paramount.

This is also true of the elderly.  In this group of people very often much has already been lost.   The elderly experience diminished senses: sight or hearing, taste or smell; and sometimes all of these including touch.

Often the elderly are experiencing progressive dementia.  The synapses of the brain no longer fire as they should; memory is lost and with memory the ability to read a book or a newspaper, watch a film and in severe cases even carry on a conversation.  If you cannot remember what was just said, you cannot converse in a meaningful way.

For those with dementia and Alzheimer’s disease reality comes and goes.  Sometimes your aunt or uncle or parent makes sense.  But often they speak of a reality that is made up of dreams, fantasies or the belief that they are still living their past lives.  My 95-year-old mother tells me she is working part time, going to the theatre and singing in the choir.  She is no longer able to do any of those things.  She is living in a senior facility.  She cannot walk and is confined to a wheel chair most of the day.   When those snatches of her past, which are more ingrained in her mind than her recent life, rise to the surface, she goes there to live.  It’s familiar, comforting.

Comfort is what she needs and deserves.  And mercy.  Understanding.

So how do we comfort ill children, aging parents, spouses who are facing cancer treatment?  With palliative care.

This system grew out of the need to provide a quality of day-to-day living that is pain-free.  Whether a person is dealing with a chronic illness or about to have chemotherapy, palliative care creates goals so that a person will experience the treatment or live with the disease free of pain.  Her or she will experience a life of comfort and hopefully a sense of peace.   Palliative care does not preclude other care to possibly cure the cancer or push back the progression of the chronic disease.

Hospice is also palliative care, but it is set within a particular time frame.  Sometimes doctors must sign paperwork stating that the client has been judged to be at the end of life.  Pain relief and comfort are provided as well as emotional and spiritual help.  Both hospice and palliative care are founded on principles that affirm life and acknowledge that death is a normal process, a part of the life spectrum and should be talked about and dealt with—not shunned and avoided.

Palliative care provides relief from pain and physical symptoms that create daily stress in a person’s life.   Its purpose is neither to hasten nor to postpone death.  Palliative care providers work with clients to integrate spiritual and psychological help and to create a support system so that patients can life as actively as is possible for them.  Palliative care provides holistic comfort and thus improves the quality of life of the client and his or her family.

This past week I had to decide whether to place my mother on hospice or to allow her the Medicare benefit of rehabilitation after she had surgery on a fractured hip.  Because she completed a 3-day hospital stay, she is allowed 1-20 days of skilled nursing paid for by Medicare.   Because of her age, I could also ask to have hospice care only.  On the hospice plan, no physical therapy would be done.  I consulted with her physician and because my mother has rebounded before, my family and I chose Medicare.  This was not an easy decision to make.

Comfort will always be my main concern as I work with my mother’s facility, doing whatever I possibly can to care for her in her last years, months, and days of her life.

If you are facing similar challenges, please comment.  Your input is valuable to me and to other readers who like you and me will someday be faced with making a decision between hospice care and palliative care.

Thanks to Google Images

6 thoughts on “Palliative Care, Hospice Care

  1. These choices are so difficult to make (read ‘excruciating’), but made easier by a good team of professionals and those specializing in geriatric care. CAREGIVING is not for the faint of heart. It always helps me to remember I’m not tending to TASKS but to a PERSON, and that doing so brings forth valuable qualities in me. It’s a refining process and like all refining processes, there’s considerable heat from time-to-time. 🙂

  2. I agree, Marilyn, that it helps to remind yourself that you are tending to a person. What’s so hard for me is that my dear amazing mother has lost so much and I have to make all these decisions for her. Quality of life!! It’s a huge responsibility and though I am an RN, it’s the daughter role that stands out. I don’t think I will ever know if I’ve made the right decisions, though others in my same situation are counseling me and telling me that I am. Today she sat in her wheel chair and went to therapy. I don’t know how I feel about that. Again, it’s a struggle for her and for me. Beth

  3. Thanks for the very clear and wise comments which help me understand these important distinctions.

  4. Hi John-
    Thanks for your comment. I remember when Greg Rausch started hospice at his hospital for cancer patients. Seems to me that was over 20 years ago. Great strides have been made in this area. When I spoke with Mom’s doctors last week I said right out: I know you were trained to heal, but I am not going to stand here and tell you to do anything to keep my mother alive. He agreed. That’s not acknowledging that death is part of life. Beth

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