As a hospice nurse practitioner, I have a calling that includes frequent encounters with individuals and families who are suffering. I want very much to alleviate the suffering, to have a solution, to be the relief. It’s another kind of suffering altogether when you want so desperately to be the answer, knowing full well that you are not the full answer.
The goal of a hospice interdisciplinary team is to provide patients with physical and psychological comfort while supporting families as they part with loved ones. We all will face physical death; this commonality of our human experience unites us.
Hospice Care vs. Palliative Care
When a person elects hospice care, they are electing palliative (comfort) care. When a person elects palliative (comfort) care, they are not necessarily electing hospice care. Let me explain.
Palliative care seeks to alleviate pain and manage symptoms to provide comfort. Likewise, hospice care also seeks to alleviate pain and manage symptoms to provide comfort. The main difference between the two types of care is regarding curative treatments. The decision of whether curative treatments will continue or discontinue is the decision required when choosing between a non-hospice palliative care program and hospice care.
Curative treatments are medical treatments focused on curing a disease (or improving the severity by treating the cause of the disease). Palliative care may be provided while curative treatments continue. But when electing hospice care, the decision is made to go without curative treatments.
What You Don’t Know
Health care providers who help you make decisions regarding health care services are to assess what you know and what you don’t know about the benefits and risks of a potential health care decision. One essential part of the hospice admissions process is to ensure informed consent. You need to know certain pieces of information to consent to the terms of your decision, with an understanding of the potential consequences.
Informed consent is extremely important. Here’s why.
Imagine you have a disease and you grow to be very sick. You are in pain and you also want to continue receiving curative treatments. Your doctor suggests a palliative program to help improve your quality of life. The palliative program suggested is hospice.
You don’t know anything about hospice and because the topic is of a sensitive nature, the doctor fails to explain the referral and their opinion on your prognosis. The doctor is attempting to protect your emotions and is not clear in the information provided to you, trusting the hospice team will continue the conversation with more clarity when you are ready.
When learning about hospice, you don’t realize that if you consent to hospice care you will not continue curative treatments. You are not informed of this important information, and you consent to hospice services.
You receive comfort care but not curative care. You don’t know you have consented to stop curative treatment. You feel comfortable for a time as your symptoms are managed, but your disease progresses because you are not receiving curative treatments. You are not a health care professional and you do not realize this.
After some time, you have become very, very sick.
What You Need To Know
- Life is a terminal illness; we all will die.
- You can choose to live instead. There is a cure.
- You have a decision to make.
- Not making a decision is a decision.
- I want you to be informed about the benefits of choosing comfort vs. cure.
- I want you to be informed about the risks of choosing comfort vs. cure.
If you are reading this and the above bullet points are not yet links, know that I am writing up a post for each point. If you do not know God (if you do not have a relationship with God through Jesus Christ), you are not alive with eternal life. You will die but you have a curable disease! God offers a curative treatment. The process is salvation, sanctification, and glorification.