COMMENTARY

Palliative Care vs Hospice Care: Guidance for Clinicians

Scott A. Irwin, MD, PhD

Disclosures

November 23, 2011

Editorial Collaboration

Medscape &

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Hello. I'm Dr. Scott Irwin from The Institute for Palliative Medicine at San Diego Hospice. I'd like to speak to you today about palliative care and compare it with hospice care.

According to the World Health Organization, palliative care is an approach that improves the quality of the lives of patients and their families facing life-threatening illness. It does this through the prevention and relief of suffering by early identification and impeccable assessment and treatment of pain and other problems -- physical, psychosocial, and spiritual.[1]

Palliative care also focuses on other domains that may cause suffering including practical issues, end-of-life care, loss, grief, and bereavement. This care is delivered via interdisciplinary teams that can include physicians, nurses, social workers, spiritual counselors, clinical pharmacists, home health aides, bereavement counselors, and volunteers, all of whom work together to match treatment interventions with patient and family goals.

The intended outcomes of palliative care are for people to have their physical symptoms under control, feel safe and know what to expect in the future, be able to continue to experience love from their friends and family, maintain their self-esteem and dignity, and find meaning and value in their lives. Palliative care may be combined with curative interventions or be the sole focus of care. Often it becomes the sole focus of care when curative interventions are no longer working or no longer desired by patients.

Palliative care is what hospice offers to patients when they only have months left to live. Said another way, hospice care is really enhanced palliative care, focused on the last months of someone's life, as well as the bereavement period that follows for the family.[2]

Evidence has shown that palliative care achieves far better clinical outcomes than standard care alone. Patients feel better and families are more satisfied with the quality of care in the amount of symptom control achieved, the amount of respect they receive from their care providers, and their access to physicians.[3,4]Palliative care has been shown to extend life beyond that of standard care alone.[4]

Palliative and hospice care are also less expensive than standard care alone.[5,6,7] In today's healthcare world where we want higher health quality with lower healthcare expenses, it turns out we already have the answer -- palliative care.

This is Dr. Scott Irwin of The Institute for Palliative Medicine at San Diego Hospice. Thank you for your attention.

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