In my mind Palliative Care is when one is designated as receiving comfort measures. Long-term treatment is discontinued. Physicians declare a patient palliative, and this entitles the patient to particular services. It is a change in focus from treatment to care measures.
Hospice care, I believe to be a philosophy of a delivery of services, either at home or in a building or institution, to ensure that the dying ensure that their appropriate medical, spiritual, social needs are being met.
This differs in the US, of course, as a physician must declare a patient palliative before they qualify for certain relief measures, both physical and financial.
In Canada, the terms are interchangeable, as we have universal health care, nor matter our diagnosis.
The Hospice movement, begun by Dame Cicely Saunders (1918 - 2005), established the first Hospice, in the UK, in 1967. As with many movements, it took time to be accepted by the medical establishment.
|Josephine, myself, 5-hour old Isabelle|
Midwives and home care
I recall midwives fighting for recognition and hospital privileges 30+ years ago when my first child was born. In this generation, they are part of an OHIP-funded program in which expectant mothers are visited, given training, and they may choose to have their children in hospital, in comfortable birthing centres, or in their homes, as my daughter did this year (2010), 6 months ago.
I credit these well-trained women, who visit pregnant women daily both pre- and postpartum. They appear when needed at any time of day or night, and teach mothers about breast-feeding, prevent jaundice, give support in sleep hygiene, ensuring that they thrive. In normal births provide an incredible system of care, much like the goals of the Family Health Teams in Ontario.
From Pediatrics to Geriatrics
I have noticed that as great progress has been made in pediatrics, we make progress in geriatrics. We are realizing the importance, as well as the dearth, of geriatricians. For those facing health issues in later ages, geriatricians realize that theirs is complex care. By the time a senior is facing palliative care, the medical establishment needs specific training. While the physician is trained to heal, they are not trained to deal well with death and dying. This is where Hospice, and experienced physicians, can meet in dealing with end-of-life care.
|No Hospice support here|
Importance of Palliative Nurses
It requires much nursing care, experience in treating pain, and comfort measures designed to ease the passing of clients and residents. The physical breakdown of the skin requires tremendous intervention in many situations. It is our precious nursing staff who can turn a client frequently.
|Communication Book for Mom's Hospice Care|
Again, much like a natural home birth, a hospice death is one infused with dignity, comfort and supportive caregiving from family, volunteers or professional caregivers. It is not limited to these people. Primary Care Staff (physicians familiar with palliative care measures, nurses who are similarly trained) are an important as medical decisions are made. There must be a realistic understanding and creation of a treatment plan, or a care plan, in the case of a palliative situation. I implore you to seek advice from a hospice organization near you.