Episode Transcript
[00:00:10] Welcome back to Louis Body and mindful caregiving. I'm Crystal Jakowski, your host, and today I really want to talk about the difference between palliative care and hospice care. And we always start with self care. So what did I do for self care? I actually played pickleball four times this last week. A couple of them were easy, low key, not a big deal, and a couple of them were a little more intense. And it felt great. And I laughed and I had a good time, and I made other people laugh, and it was great. It was just fantastic. So, on to our topic of palliative versus hospice.
[00:00:52] This is something that you can do a bunch of research on and just do Google searches to try to understand it, and yet I really want to just break it down and make it a little bit easier for you because it can get a little bit confusing.
[00:01:06] Hospice care is end of life care. Typically you have one or two doctors who have said this person has less than six months to live and they need the comfort care. They are no longer treating any part of the disease because any disease that they have, the treatment is actually going to be worse than just not treating. And the focus is literally on comfort care. So you're on pain meds and you're trying to just ease and make things a little better for them in that realm.
[00:01:44] So they bring in the hospital beds, they have people that come and sit with them. Hospice can declare that the person has passed. If you're doing hospice, then you don't have to call an ambulance when the person passes because the hospice nurse can say, yes, it is done, and then you can just call the funeral home.
[00:02:08] So hospice is the pre.
[00:02:11] Hospice is right as you're actively dying. It is as your loved one is exiting this world. And that's the extra in home support that you need. And they need to get them through those moments. The overseeing and every area has it different. Every area treats hospice differently. And some of them have people with you more regularly. Some of the hospices, they just kind of check in daily or weekly and help adjust as necessary. So you'll have to look and see what it is in your area and who you can get to help you with your loved one.
[00:02:55] Palliative is pre hospice palliative care. Typically a doctor has said, yes, this person has a terminal illness. Now, palliative kind of has a range.
[00:03:13] In hospice, you have said that the treatment for the disease is worse than actually just letting it go. The treatment will cause more side effects, more discomfort, more upset than just allowing it to take its natural course.
[00:03:33] Palliative. You may still be treating for the disease, but you know that this is terminal, that you will pass or your loved one will pass. And so now you have a doctor who has said perhaps palliative and bringing someone in to help with their comfort would be a better space to be in. Palliative can also help with occupational therapy, which is making sure that the space that your loved one is living in is safe and they won't fall or whatnot.
[00:04:09] I mentioned in the last episode, my personal episode, that I have now put my mom on palliative care.
[00:04:18] My mom had not been sleeping from November, and it is now mid March.
[00:04:27] I have been working with the doctors since November to get her pain relief at night, as well as how can we get her to sleep? And it's just not working. And it's just not working. And the doctor said, you know what, things are not helping your mom the way that we would want them. And I think that we need to look at palliative if your mom is comfortable with that. The doctor suggested it, and so we went ahead and put her on palliative. My mom has a doctor that comes into her house once a month and evaluates where she's at and what she's doing, what she needs. My mom has decided that she does not want to treat anything anymore.
[00:05:13] My mom is on palliative at night. Her hips hurt, and that is what makes it so that she can't sleep. Doesn't hurt during the day. It's only at night. Now, the doctors have said you could get injections into your hips and that might help alleviate some of the discomfort and the pain. My mom has said, no, I'm not treating anything else. She's on palliative, you're not treating anything else.
[00:05:43] Sometimes when you're on palliative, some doctors will still try to improve your quality of life and hopefully give you a little bit longer. So it's not that you're curing the disease because you have a terminal illness. It will not be cured. There is a definite path to this disease that you are dealing with, but there are levels. So there are the people who say, you know what, give me antibiotics, give me pain meds, do CPR, keep me alive at all costs as long as you can. We're going to treat the underlying issues of what are going on. And then there are people that say, you know what, I don't necessarily want the CPR, but go ahead and give me antibiotics, do fluids. If I'm dehydrated, you might say, I have a pain in my wrist. And some people on palliative are going to say, okay, let's do physical therapy. Let's figure out what is going on with your wrist so that we can make it better, so that you're not in pain with your wrist, and so on. Palliative, you might get physical therapy and you might work that out, and then you have comfort and relief because you have been able to do that.
[00:07:03] Other people in palliative say, I don't want to deal with physical therapy. I don't want to fight with it. Just give me drugs. Just give me drugs to make it not hurt. That's where my mom's at. My mom says, no more. I don't want to do physical therapy. I don't want the shots in my hip. I don't want to understand the underlying issues. I just keep me comfortable. Now, palliative comes first, and as they decline, at some point, the palliative people will help. You know, it's time to put your mom on hospice. There's nothing left that we can do. She is declining enough that we think that this is where she'll be. We don't think she'll be here within six months.
[00:07:53] You don't have to make that choice. You don't have to make that decision. However, they can help support you in it. The palliative care that I was able to get into for my mom, they also have a hospice team, so it's not like they'll be transferring my mom from here. We're a palliative team. And then there's the hospice team. It's all kind of in house. It's called true palliative care. T r U. And so she's on palliative. She doesn't want to treat anything else. If her heart is challenged, if she's in heart failure and that kind of thing, it's okay. We're not going to add drugs for that because she wants to reduce the number of drugs that she's on. This is her decision as a patient on palliative care. So as she declines, as her body starts shutting down, at some point, this palliative team will say it's time to hand her to the hospice team, and then we will move forward with the other comfort measures that we need to do, whether that's increased pain meds or whatever the doctors decide needs to happen. Without extending her life, without trying to fix any issues, without adding medications that would fix an underlying thing like liver failure or heart issues or kidney function, it's simply keep her comfortable. Literally, simply keep her comfortable. It is comfort care, so I hope that's clear as mud. Palliative is you have a terminal diagnosis. You know that you are not going to live through this. Now, people can be on palliative care for years. I have heard of a couple of people who've been on it for ten years because they do have this terminal diagnosis, and yet their body is healthy enough that they are still functioning and doing well. So they are still on palliative, not hospice. So palliative can be a much longer time frame. Hospice is generally six months or less because doctors have deemed it that this person has declined to that point.
[00:10:15] Palliative, you do a lot more things to try to fix. You might do a lot more things to try to fix and help alleviate problems, high blood pressure, that kind of thing. You might actively be trying to enjoy your life more. You may have a terminal diagnosis, but that doesn't mean that you stop running or you stop climbing or you stop welding and woodworking and all of the things that you love.
[00:10:44] You may, in palliative care, want to continue enjoying all of these things in life, and palliative will help you do that.
[00:10:52] And then once you have declined to the point where you can't do all of those things that you loved, you can't be as active. And we are no longer trying to extend it. We are accepting the fact that your body has declined to this point. Hospice comes in and they support you throughout the rest of that. So I hope that makes sense. I hope that helps you a little bit.
[00:11:17] There are tons of websites that have so much information, and if you need more, I highly encourage you to look it up. They both have comfort care. They both have the focus of making sure that the patient is okay and helping move them through the decline of a terminal disease diagnosis.
[00:11:44] Yeah, I think that's everything I have to say on this topic.
[00:11:48] If you have questions, feel free to reach out. And in the meantime, give yourself a little bit of love, give yourself a little bit of self care, and I hope you come back for my next episode of Louie Body and mindful caregiving. Take care.
