David Tsai, M.D., a geriatrician at the Hebrew Rehabilitation Center and medical director of its Palliative Care Program, explains the following similarities and differences in hospice and palliative care:
1. Hospice care is available for patients whose life expectancy is six months or less, as determined by their physician.
2. Patients must sign a form acknowledging that they will forgo curative efforts that are understood by physicians to not be really productive.
3. Hospice care takes place in the home, long-term care facility, or hospice residence.
4. Hospice extends care to the family into the period of bereavement.
Palliative Care can be described as a philosophy of caring and compassion which can be requested at any time during an illness, beginning at the time of diagnosis and throughout – even if aggressive, curative treatment is being sought.
Palliative-care consult teams include a palliative care physician, a clinical nurse specialist, a social worker, and a chaplain. As a chaplain, I have been involved with palliative care for some time and can attest to the fact that it is a caring and compassionate way to face the trials of illness.
Palliative Care
1. Does not depend on life expectancy
2. Is best introduced early in care
3. May be pursued at the same time as curative efforts
4. Is often provided in acute-care hospitals and is also offered in long-term care and post-acute care facilities
5. Has as its goal to provide a better understanding of medical care choices, detailed practical information and assistance, and emotional support for the patient and family.
When each of us comes to terms with the reality that our lives are finite, and when not betraying one’s own sense of dignity outweighs the pressures put upon us by others with different views, the topic of “death with dignity” will not seem so undignified.
Speaking early to a medical team about our wishes, choices, values, prognosis and goals of care will better enable each of us to maintain the level of dignity that is important to us – even at the end of life.
Laurie Dinnerstein Kurs