Hospice. What about Palliative Care?

I read a blog post recently about care providers needing more education on end of life care. One of the things this blogger shared was "five reasons end of life discussions are avoided" (Julianna Paradisi). These reasons were taken out of context from a MedScape article. They were: "1. Patients get depressed. 2. The truth kills hope. 3. Hospice or palliative care reduces survival. 4. This talk is not culturally appropriate. 5. Prognosis is unknowable." While many of these "reasons" frustrated me, number three was the most frustrating. 

Unfortunately, a lot of health care professionals don't really know much about hospice or are scared of it themselves. Bring in palliative care, and there is even more confusion/misinformation. 

As the Paradisi blog suggests, we, as nurses (and all licensed medical staff, in my opinion), need education on how to broach the subject of end of life. I was so passionate about this after, that I immediately emailed (and later talked on the phone to) my boss about getting my staff trained in this and asked what I could do to help this happen. 

So, what is hospice? In general, hospice focuses on the last 6-12 months of life. It is a means for offering dignity, comfort, and peace to the end of life. It is not just for patients, it's for their families, too. Hospice may take place as an inpatient (in the hospital or a hospice center) or an outpatient (at home) setting. Some families are equipped to be with their family and care for them in the last months of life, others aren't; some people just don't have family so their options are more limited. Hospice care includes palliative or supportive care. 

So what is palliative care? As mentioned already, palliative care is included in hospice care, however, a patient can receive palliative care without being in hospice. Palliative care is for patients with serious illnesses. Like hospice, it is something that doctors fail to give to their patients until it is almost too late. Many believe palliative care is only for those who are close to death, but I have seen it used in those with chronic illness, such as Crohn's disease. Palliative care is primarily about comfort. 

More to come on these subjects and many more. It's been a busy couple of weeks with school and work. I hope to be able to add more this weekend. 

Also, looking forward to spreading some information about Sickle Cell Disease and Hemophilia, issues that I see at work daily as well as that affect friends of mine.