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Types of Care Available to Those Who Are Dying

Kathryn Patricelli, MA

There are two types of care available to those that are dying - palliative and hospice. Even though the terms are sometimes used interchangeably, there is a distinction between the two.

Palliative care is a form of medical treatment focused on reducing the severity of disease symptoms (such as pain) or slowing the disease's progress, rather than providing a cure. This type of care is typically provided by a team of medical professionals at a medical facility, such as a hospital or nursing home. The goals include making the person as comfortable as possible and addressing quality of life needs (in physical, psychological, and spiritual realms) in the time remaining. Palliative care can be delivered at any point during an illness and for an extended period of time as necessary.

Hospice care is a specific form of palliative care that is often limited to the last six months of life (determined by a doctor's diagnosis). Hospice care is offered 24 hours a day, and can be provided at an individual's home, a hospice care facility, or a hospital/nursing home.

The focus of hospice care is to provide pain management and medical care, emotional support, and spiritual counseling for the dying patient, and similar emotional and spiritual help and support for family members. Counseling about death, dying, and the grief process; facilitation of making amends and closure; respite care for family caregivers; and bereavement groups and support are some of the services typically provided by hospice. Hospice teams generally include medical doctors, nurses, social workers, psychologists, nursing assistants, trained volunteers, and spiritual advisors.

Hospice care is sometimes covered by private medical insurance and sometimes not covered. Out of pocket (not covered by insurance) hospice services generally cost several thousand dollars. Therefore, it is important to be aware of what your private insurance covers and doesn't cover, and plan ahead while still healthy for the possibility that you may one day require hospice services.

Unfortunately, some people do not receive hospice or palliative care before dying. Still others are referred when they are too sick to realize the full benefits of available hospice services. In some cases, a doctor is at fault; he or she may be reluctant to refer a patient because it can be difficult for health care providers to admit that there are no other options for curing a particular condition. Other times, as is sometimes the case with 'macho' men or women; patients and caregivers may view these types of care as giving up or a "cop-out". Such attitudes are incorrect, of course.

Choosing hospice or palliative care is most decidedly not about "giving up". Instead, it is a practical, reasonable and very effective method of ensuring that your last days will be as good as they can be. While death may be inevitable, unbearable pain and extreme discomfort does not have to accompany the process. A person who has the foresight and strength to ask for support and care is not a "wimp," but instead a strong and intelligent person who wants to obtain the best care for himself or herself and family during the time he or she has remaining.


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