Palliative Care and Hospice: Quality of Life for Patients with Serious Illness
Hook Law Center, P.C. recently had the pleasure of hosting Dr. Marissa Galicia-Costillo from Sentara Norfolk General at our most recent Coffee with Colleagues seminar to discuss the difference between hospice and palliative care. While many people have heard of hospice, few have heard of palliative care, and even fewer understand the difference between the two. A brief synopsis of the takeaways from the presentation are provided herein.
Palliative care, by definition, is medical care for people with serious illness that focuses on relief of symptoms to improve the quality of life for the patient and the family. Unlike hospice care, palliative care is appropriate at any stage of a serious illness (such as organ failure, Parkinson’s, dementia, and cancer) and can be provided in conjunction with curative treatment. As a result, it is never too early to bring in a palliative care team who can help define what goals you have for treatment.
Instead of treating the actual illness, a palliative care team focuses on various symptoms such as pain, shortness of breath, nausea, loss of appetite, fatigue, and sleeplessness. Aside from these physical symptoms, the team may also address mental, social, and spiritual issues. The goal with palliative care is to manage symptoms to improve overall quality of life. Because quality of life varies among individuals, a palliative care team works to understand what is important to you and help set treatment goals based on your priorities. From there, the team uses your goals to guide the care you receive.
In our area, palliative care is currently provided in facility settings, most often a hospital.
Hospice care is a type of palliative care provided during the last stage of a serious illness. At such point, curative treatment ends and the focus becomes comfort management. Hospice eligibility requires the patient to be considered “terminal” and prepares the patient and the family for end of life. Essentially, the doctors indicate that it would not be surprising if the patient were to die within six months. The goal is to stop focusing on treatment, and allow an individual to spend their last days as comfortable as possible.
Hospice care can be provided in a facility setting and in the home. Our area does not yet have a hospice house, although plans are underway to build one.
Ask Kit Kat – Great Danes Saved
Hook Law Center: Kit Kat, what can you tell us about 84 Great Danes that were rescued in New Hampshire?
Kit Kat: Well, this story has a happy ending, but it was not such a wonderful existence for 84 Great Danes that were recently discovered in a puppy mill in northern New Hampshire. They were housed in a 15,000 sq.ft. mansion. The mansion may have had crystal chandeliers, but it was a prison of sorts for the dogs. Living in a mansion doesn’t sound too bad, but the place was a wreck. There was trash everywhere, and some wooden floors were covered in diarrhea. In other rooms, the smell of urine was so strong, that rescuers had to take breaks and tag team each other during the removal of the dogs to a shelter.
The staff of the Animal Rescue Team are to be commended for the way they handled the rescue and re-location of these dogs to a shelter. Neither dog nor human suffered any injuries. The whole process took and entire day—from 5 AM to 11 PM, and it rained heavily that day. Dogs had to be coaxed one-by-one to get in cages. Some of the dogs were so large, though, they couldn’t fit into standard cages, so the team secured a couple of horse trucks to carry them. Once at the shelter, the dogs have been receiving veterinary care. Some have pressure sores from spending too much time on hard surfaces. Others have issues with their eyes or cardiac problems. Volunteers are helping to fill staffing gaps. A lot of hands are needed to care for so many large animals. They are providing the dogs with lots of tender, loving contact and help in the feeding process. All together these 84 dogs require 225 pounds of food per day! The dogs have also received 9,946 medical treatments to date.
This is a wonderful story that indeed ended well; however, it’s a shame any animal has to endure such treatment, even for a portion of their existence. (Holly Hazard, “Animals Saved: 84 Great Danes,” All Animals, September/October 2017, p.6)
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