Hospice and Palliative Care Programs

Sarah DiPadova, MSN

When patients and their families hear the word “hospice,” they panic. Misconceptions, myths and lack of education about what hospice is have resulted in patients being admitted to hospice later in the dying process than recommended. Because of this delay, quality care and valuable support are also delayed. A referral to palliative care could be the key to ensuring a timelier transition into hospice for patients and their families. Full support from a palliative care team leads to a seamless transition to hospice care and the resources it offers at the appropriate time. 

It is not easy for a physician or clinical care team to refer a patient to hospice care. Ultimately, it’s a very scary word if there is a lack of proper education. It is understandably difficult for patients and families to transition from active treatment, thinking their health will improve, to what they may consider as giving up. This gap can be bridged by starting earlier in the disease process with a referral to palliative care. In this continuum, palliative care becomes the much-needed middle level of care for patients who are being treated for life-limiting diagnoses but are not actively dying. For example, this can be helpful for patients with diagnoses of cancer, ALS, leukaemia or Alzheimer’s or who are end-stage cardiac, respiratory or kidney disease.

"Palliative care practitioners are skilled in recognizing the decline process and know when to introduce the hospice conversation based on patient needs, emotional status and physician orders."

Palliative care offers additional education, support and care to patients and their families. There is no time limit to palliative care, and patients can continue to seek new treatment options with specialists, so it can be very beneficial. For physicians, having nurse practitioners monitor patients and manage symptoms can help prevent needless office visits and hospital admissions. Updates from a palliative care team provide physicians with a clear understanding of what is going on with patients, both mentally and physically. This alone can improve patient/physician relationships and can save physician practices valuable time and money. 

Substantial benefit comes from the relationship that a palliative care team builds with patients and their families. Information about their life-limiting diagnoses, symptom management, support during emotional milestones, and proper hospice transition can help patients and their families make difficult decisions at the best times.

Palliative care practitioners are skilled in recognizing the decline process and know when to introduce the hospice conversation based on patient needs, emotional status and physician orders. Every patient’s care plan is created specifically to their needs and physician’s orders, so there is no predetermined time to introduce the hospice option. But when the appropriate time comes, the palliative care team can offer the education and support necessary to make a timelier, smoother and less scary transition. This appropriately timed hospice admission gives patients and their families more support when needed.