If there are two terms that I have found most of the patients that I take care either of at home or in the hospice misunderstand, it has to be hospice care and palliative care. It seems that most people do not actually know that there is a difference and will therefore tend to use them interchangeably as though they connote the same meaning. The truth cannot be further from that.
Why palliative care gets a bad rap
The notion that comes to many people when you mention that so and so is receiving Palliative care is that they are surely dying. That there is nothing else to do but part with their loved ones, write a will and breathe their last. It is often confused with hospice care.
Yes, there is a difference between hospice and palliative care. Hospice care deals with taking care of a patient without any intent to treat them. As one goes to the hospice, doctors have done their best but they are honest enough to tell you that no cure or treatment can heal you. You are terminally ill and no medicine or curative measures can be done to have you back. The only thing remaining is valuing your human dignity even in you last days, giving you pain meds and looking after you in those sunset days.
Palliative care is a bit different. It could be done when you have or don’t have intent to treat the patient.
Palliative care could be done to patients who have cancer and are receiving chemotherapy treatment to get rid of the cancer. It could also be done to those getting renal dialysis with the intent to heal your kidneys. Yes, the disease is chronic but the doctors may still have a glimmer of hope that you will recuperate.
When palliative care starts and passes the baton to hospice care
Palliative care starts when the disease has been diagnosed, continues when you are receiving the curative treatment and goes on even when doctors have found out that you cannot be healed. At this stage where it is found that you cannot be healed, we can now say that the palliative care has morphed into hospice care.
But the truth though is that hospice care is still palliative care. Palliate care is the big umbrella where hospice care finds a shade.
Hospice care is also termed as end of life care whose sole purpose is to improve the quality of life even as you depart.
It will involve spiritualism, psychological support and the calling up of your family members so that you may tell them anything that you might not have told them all through your life. The caregivers will also be there to comfort the family at these difficult moments as well as assure you that you are going to a good place and therefore need not worry.
When someone should be offered palliative care
Palliative care does not have to wait. You could begin it immediately when you have gotten the diagnosis of a chronic illness without having to wait upto a time when you are receiving non-curative treatment.
Related: Hospice care and its purposes
Palliative care could be done for years or just a few days before one passes away.
Can hospice care be done at home?
While hospice care can be done at home, it is never the best thing. For one, it ties down the family members so much that they are unable to do anything since they are already in grief. They might not be able to work or move about their daily hustles. The patient too will feel as though they are a burden to their relatives. Their quality of life might deteriorate since in a home set up, one might not have the right pain meds or home care equipment to give the patient the best care possible.
The patient might feel embarrassed and uneasy when their relatives are taking them for toileting and other personal hygiene practices such as washing. Not unless you have a live-in caregiver who is not a relative to the patient, then hospice home care can be tough. This though could push the cost of hospice care at home up.
With hospice home care, one should expect that the condition of the patient will deteriorate with time. You need to have a comfortable hospital bed where the patient lies on, have wheelchairs, grab bars in the toilet as well as bidet toilet seats.
There will be moments of social awkwardness when the patient is not able to say what they want. They might have trouble telling you of their worries. You would need to invite some clergymen to come assist the patient talk things through and make things right with the family members.
After the death, a good home hospice care program should see to it that the relatives have gone through the different stages of grief. It should console them and walk with them through the pain of losing their loved one.
