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Hospice and Palliative Care: A Guide for Families, Caregivers, and Medical Professionals

Due to many factors, including illness, disability, and issues with mobility, many senior citizens find themselves socially isolated. For this reason, many senior citizens benefit from end-of-life care. End-of-life care can also be a rewarding career for empathetic individuals who want to work with people, and it’s a field that will likely experience a significant increase in demand as the significant Baby Boomer demographic continues to age.

There are several types of end-of-life care, and it is also very possible to find personalized care options that cater to the specific needs of you or your loved one. Two major types of end-of-life care are hospice care and palliative care.

What Is Palliative Care?

Palliative care is a popular option for end-of-life care for seniors who are also going through treatment for chronic illness.

What Is the Focus of Palliative Care?

The primary goals of palliative care include the following:

  • Treatment of physical ailments;
  • Care for emotional needs;
  • Care for spiritual needs;
  • Care for social needs;
  • Coordination with other medical professionals;
  • Development of a care plan that aligns with the patient’s goals;
  • Holistic care for the patient’s needs in general.

While the goal of palliative care is not necessarily to extend a patient’s life, it is often found to do so. For example, a study published in the New England Journal of Medicine reported increased longevity in patients with metastatic non–small-cell lung cancer who received palliative care early. While there are many possible reasons for this phenomenon, one possible explanation is that because palliative care teams seek to improve communication between the patient and their treatment teams, issues may be addressed more promptly. Better communication and closer monitoring may even reduce treatment costs, as it may prevent hospitalization or other serious treatment needs.

Who Can Receive Palliative Care?

As stated, palliative care is specifically meant for patients dealing with a terminal illness. Often, these patients are senior citizens, but they are not necessarily so. The timeline for palliative care can vary greatly; some people will benefit from palliative care for only a few days, while others may utilize it for years.

Some common illnesses that prompt palliative care include:

  • Cancer;
  • Cystic fibrosis;
  • Heart disease;
  • Lung disease;
  • Dementia;
  • Multiple sclerosis.

What Services Are Provided Through Palliative Care?

It is important to note that the goal of palliative care is not to delay death, although it may work in conjunction with other medical care that does. Services provided through palliative seek to address many issues, including the following:

  • Depression;
  • Stress;
  • Pain;
  • Breathing issues;
  • Sleep disorders;
  • Nausea;
  • Gastrointestinal issues.

Palliative care can be provided in many settings, including hospitals, nursing homes, and patients’ personal residences.

Who Provides Palliative Care?

Palliative care is often handled by an entire team, rather than by a single individual. At a minimum, a palliative care team includes a doctor, a CNA or HHA, and a social worker. Nurses in palliative care are often CNAs or HHAs, although CNAs are more common.

Given the growing population of seniors and adults managing chronic conditions for longer in life, nursing positions in palliative care are experiencing significant job growth and can be extremely rewarding. CNAs will typically spend their day assisting the client and creating reports on their condition. More specifically, the duties of a CNA can include:

  • Sample collection;
  • Meal delivery;
  • Record maintenance;
  • Observation of vitals;
  • Medication management;
  • Hygiene care;
  • Mobility assistance;
  • Wound care;
  • Help with household chores
  • Social support.

Paying for Palliative Care

As the majority of people who utilize palliative care are elderly, many will use medicare to help them pay for it. Medicare covers many aspects of palliative care, such as routine and continuous home care, and inpatient care. Many forms of private insurance also cover palliative care, but may only cover inpatient care or care in a facility.

What Is Hospice Care?

Hospice care is also for patients who have received a terminal diagnosis. Hospice patients typically live out the rest of their lives in hospice care. The major difference between palliative care and hospice care is that palliative care can begin upon initial diagnosis, whereas hospice care takes place during the final phases of the illness, and after life-saving or life-extending treatment has largely stopped.

What Is the Focus of Hospice Care?

The primary goals of hospice care are similar to those of palliative care and  include:

  • Treatment of pain;
  • Care for emotional needs;
  • Care for spiritual needs;
  • Care for social needs;
  • Holistic care for the patient’s needs in general.

As the major difference between palliative and hospice care is the stage of diagnosis, the goals of hospice care more so emphasize pain relief and emotional care, rather than additional support during medical treatment.

When Is Hospice Care Necessary?

As previously stated, hospice care usually begins during the final stages of the patient’s life, once it has been established that little to nothing else can be done. However, the decision for when hospice care should be utilized needs to be made by the patient or whoever is ultimately in charge of making their medical decisions.

What Services Are Provided by Hospice Care?

The services provided by hospice care are almost identical to those provided by palliative care, and seek to address issues like:

  • Depression;
  • Stress;
  • Pain;
  • Breathing issues;
  • Sleep disorders;
  • Nausea;
  • Gastrointestinal issues.

Hospice care can be provided in many settings, including hospitals, nursing homes, and patients’ personal residences.

Who Provides Hospice Care?

Hospice care providers often comprise the same care teams involved in palliative care. In addition to a hospice CNA, physician, and sometimes a social worker, hospice care also often includes the involvement of a counselor, spiritual assistant, and volunteers. Additionally, it is common for hospice care to be delivered in the patient’s home, so there will be more home health duties involved for the nurse or nurses involved.

Paying for Hospice Care

Hospice care is covered by Medicaid and Medicare. Many forms of private insurance also cover hospice care, although it may not cover hospice care in the patient’s private residence.

Additional End-of-Life Care Resources

Helpful information and resources for end-of-life care include:

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