By Alia Tuqan, M.D.
November has been designated “National Hospice and Palliative Care Month” to bring awareness to hospice and palliative care. When I am the hospital’s palliative care consultant, physicians frequently ask me to visit their patients. When I introduce myself at bedside, patients and relatives often ask, “What is palliative care?” and “How does it differ from hospice?” Here’s how I explain the differences.
Palliative care is an interdisciplinary field dedicated to the prevention and relief of patient suffering. The multispecialty care team, which includes physicians, nurses, social workers and chaplains, focuses on preventing or managing ailments, such as pain, shortness of breath and nausea, common with various diseases.
Hospice – a care-delivery system for individuals with terminal diseases near the end of their lives – falls under the umbrella of palliative care. It focuses on preventing or relieving suffering to allow individuals better quality of life in their final stages and to die comfortably and with dignity. To enroll in a hospice program, individuals agree to focus on comfort, not cure, and have a limited life expectancy of about six months. Hospice can be provided at home or in nursing homes and hospitals. An interdisciplinary team of physicians, nurses, aides, social workers, chaplains, and bereavement counselors delivers the care.
Palliative care can benefit non-terminally ill patients as well. In 2010, a landmark study published in the “New England Journal of Medicine” showed that patients who received standard cancer treatment plus early palliative care – versus cancer treatment alone – reported significantly better quality of life and mood. They also tended to live longer, despite receiving less-aggressive care.
An important aspect of palliative care, and all medical care, for that matter, is advance care planning – a process of making decisions about future medical treatment. It involves communication among patients, their family and close friends and their healthcare providers about the patients’ future medical wishes when they can no longer speak for themselves. It is better to start the process sooner rather than later.
Here are a few practical steps you can take to prepare:
• Complete an Advance Health Care Directive, a legal document in which you make your medical wishes known and identify a surrogate decision maker, also called an agent, to help communicate your medical wishes.
• Discuss your medical wishes with this person and other close family and friends, as well as your doctor.
• Keep copies of your advance directive at home and with your agent, physician and local hospital.
Although talking about advance care planning and end-of-life care can be uncomfortable for some people, preparation helps guide family and friends to make difficult medical decisions and ensures you get the medical care you want when you can no longer speak for yourself.
Dr. Alia Tuqan is a board-certified geriatrician with the highly regarded UCLA Geriatrics Program in Santa Monica and Westwood. For more information, call 310.319.4371 or visit www.uclahealth.org.