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Talking to the Doctor

Palliative vs Hospice care

In any discussion with the doctor of a patient facing a life limiting illness, it’s important to distinguish between palliative care vs hospice care. Know the Difference.

Palliative care focuses on relieving symptoms associated with the patient’s condition such as pain, nausea and constipation while receiving active treatment and continuing through different phases of their life limiting disease.

Hospice care includes palliative care but hospice is focused on terminally ill patients when treatment is no longer curative during the last 6 months of life assuming the disease takes its normal course.

Understanding where doctors stand

Even though doctors are trained in patient communication, they can be ill at ease with patients they have treated for an illness that cannot be cured.

Doctors are human. They can find it difficult to break bad news and may feel as if they've failed their patients when treatments they have prescribed don’t provide a positive result. Doctors are in the profession of healing, and recommending hospice may go against their instincts and training as healers. 

Yet a growing number of physicians in many areas of practice recognize that hospice organizations are able to provide care and comfort to patients when treatment has done all it can. Caregivers should feel free to ask about the patient’s doctor’s views on hospice.

Creating a good conversation

Consider the following when you’re preparing to enter a discussion with a physician regarding treatment for a life-limiting illness.

  • Gather information. Knowing as much as you can about the illness in question – its diagnosis, progression, treatments, and so forth – will enable you to make the most of your relationship with the doctor. Patients and caregivers may not be in control of the illness, but they can be in control of the care.
  • Take a friend or relative with you. Medical information can be overwhelming in its complexity. Having a person there to take notes or to listen is helpful.
  • Take your time. Don’t feel rushed out of an appointment. Be sure to ask your doctor, nurses and other medical professionals to explain things fully, refer you to outside resources, and provide a rationale for their recommendations.
  • Remember that you are not necessarily “giving up.” Talking about hospice only means you’re planning and understanding options. Feel free to communicate this to the physician. Many doctors are relieved when the inquiry comes from the patient or caregiver.
  • Remember your role. As a caregiver, you are affected by the patient’s treatment. You should represent to the doctor the reality of what that means.

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