Because the words "hospice" and "palliative
care" are referred to throughout this website there needs to be a
common understanding of what they mean. The National Hospice
Organization Standards and Accreditation Committee offers the
following definitions:
- Hospice - A hospice program provides
palliative care to terminally ill patients, and supportive
services to patients, their families, and significant others, 24
hours a day in both home and inpatient settings. Physical, social,
spiritual, and emotional care is provided during the last stages
of illness, during the dying process, and during the bereavement
by a medically directed interdisciplinary team consisting of
patient/family, professionals, and volunteers.
- Palliative care is a treatment that
enhances, comforts, and improves the quality of the patients
life. No specific therapy is excluded from
consideration. The test of palliative treatment lies in the
agreement by the patient, the physician, the primary caregiver,
and the hospice team that the expected outcome is relief from
distressing symptoms, easing of pain, and enhancement of quality
of life. The decision to intervene with an active palliative
treatment is based on the treatment's ability to meet the stated
goals rather than its effect on the underlying disease. Each
patient's needs must continue to be assessed, and all treatment
options explored and evaluated in the context of the patient's
values and symptoms.
Hospice care is palliative, rather than
curative care. Palliative care involves a change in treatment
goals from cure of the patient's underlying disease to provision of
comfort and relief from distressing symptoms. Because palliative
care emphasizes the management of symptoms, with special attention
given to the control of pain, hospice care requires its medical and
nursing staff to become highly skilled specialists in the control of
pain and other symptoms. Quality of life demands that
physical symptoms be adequately controlled, enabling patients to
devote their energies to other important issues, such as family
reconciliation and spiritual concerns.
In traditional health care settings where cure is the primary goal, symptoms receive much less attention because
care is focused on curing the underlying disease. How ever in
hospice care treatment is re-focused. Symptoms which interfere
with the quality of life become the focus of treatment.
Pain and many other frightening and
distressing symptoms that may accompany a terminal illness, such as
nausea, vomiting, constipation, and weakness, interfere with quality
of life by creating discomfort, anxiety, fear, and worries about loss
of control, not only for patient but also for family members.
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