Ask The Expert: Hospice Care
Dr. Chirag Patel, The Hospice of Dayton in Dayton, Ohio
Q: What is palliative care? What is the difference between palliative medicine and hospice?
A: The goal of palliative care is to relieve suffering and provide the best possible quality of life for people facing the pain, symptoms and stresses of serious illness. It is appropriate at any age and at any stage of an illness, and it can be provided along with treatments that are meant to cure.
Palliative care treats people suffering from serious and chronic illnesses including cancer, cardiac disease such as congestive heart failure, chronic obstructive pulmonary disease, kidney failure, Alzheimer’s, HIV/AIDS and Amyotrophic Lateral Sclerosis (ALS).
Patients with these and other serious illnesses may be living with symptoms such as pain, nausea, insomnia, fatigue, loss of appetite and shortness of breath. They may need help making treatment decisions, dealing with anxiety or exploring the spiritual aspects of their lives. Families may need someone to explain their loved one’s symptoms, calm fear and help them understand what to expect as a disease progresses.
Hospice care is a subset of palliative care for patients expected to live six months or less who are no longer responding to curative or life-prolonging treatment. Hospice care involves many types of health care professionals to cover the medical and psychosocial needs of patients and their families. This care can be provided in the home, nursing facilities or dedicated inpatient units. After the Medicare Hospice Benefit was established in 1983, dedicated professionals who had great compassion and empathy for patients with terminal illnesses fueled the rapid growth of hospices across the nation.
For those with chronic disease who require comprehensive medical and emotional care — but are not candidates for hospice care — a palliative care team can offer expert and compassionate support. Team members can work with patients and families to alleviate distressing symptoms and meet the emotional needs of those suffering from life-limiting or serious chronic, debilitating illnesses.
Palliative medicine experts focus on relieving complex pain, breathing difficulties, agitation, delirium and all associated symptoms that impact quality of life so severely. For example, they can provide treatment for very complex pain syndromes using aggressive but appropriate medications. In addition, the team can address emotional decision-making such as goals of care, whether and when to resuscitate a patient, and withdrawal from a ventilator or other life-sustaining medical interventions.
Palliative care is a partnership of the patient, medical specialists and family. Usually a team of experts, including palliative care doctors, nurses and social workers, provides this care and works together with the patient’s own doctor. Massage therapists, pharmacists, nutritionists and others may also be part of the palliative care team. These caregivers spends as much time as necessary with the patient and family, providing support by controlling the patient’s symptoms, helping to understand and manage treatment options and goals, and assisting with navigating the health care system.
When physicians, nurses, social workers or chaplains have a question about a patient’s eligibility for hospice care, the palliative medicine team can provide answers. Their expertise is valuable in counseling very distraught patients and their families. These episodes can be very disheartening and complex, requiring much time and follow-up to eventually lead to an acceptable and peaceful conclusion. Palliative medicine nurses and physicians have the time and professional experience to deal with these situations, freeing up attending physicians during their busy day.
Palliative care physicians and nurses were drawn to this specialty because they want to give compassionate care, fill a void in expert care, but most of all, improve the quality of life for seriously ill patients and their families.
If you think palliative care might help you, ask your doctor for a referral to a palliative medicine specialist. The palliative care team will do their best to relieve suffering and provide the best possible quality of life for both you and your family.
Meet The Expert:
Dr. Chirag Patel, MD – Palliative Medicine Specialist.
Contact the Hospice of Dayton at (937) 256-4490 or visit www.HospiceofDayton.org.