1. What is a Hospice
Hospice is not a place or a building, but rather a philosophy of care that involves professionals and volunteers who provide medical, psychological, and spiritual support to terminally ill patients and their loved ones.
2. What is palliative care
World Health Organisation defines it as an approach aimed at alleviating the physical, psychological, social and spiritual suffering of those with life-threatening illness from the point of diagnosis onwards. In a nutshell – palliative care aims to relief suffering; not just care for the dying!
Palliative Care provides quality of life and assists the patient to live as actively as possible. It is applicable early in the course of illness in conjunction with other therapies that are intended to prolong life such as antiretroviral therapy and continues until the end of life.
Palliative Care provides a support system to help the family, friends and other caregivers to cope during the patient’s illness and during bereavement by providing support, counselling, comfort and education. For the family, there may be difficult issues after the patient has passed away, and the hospice bereavement team is there to help.
3. Who provides palliative care?
Palliative care is holistic care and is provided by an interdisciplinary team usually nurse-led, with home-based carers, social workers, auxiliary social workers, medical support (often voluntary support), pastoral care and trained volunteers, who all make up the care team.
4. Where is palliative care provided?
Palliative Care is provided wherever a person’s care takes place, whether this is the patient’s own home, at school, in a care facility, in a hospice inpatient unit, in some hospitals, or outpatient or day care centres.It can be at work, in some prisons. Palliative Care is not limited to any one care setting.98% of patients are cared for in their own homes.
5. How does the patient access palliative care?
Once you have been diagnosed with life-threatening illness ask your local doctor or clinic sister to help you contact your nearest hospice or phone 021 531 0277.
- Patients are referred by doctors, nurses or other health services or practitioners
- The patient themselves, friends or family members
- Community services such as home-based care organisations
- Patients may only be admitted if they or their guardian gives consent.
6. Which patients qualify for palliative care?
All those who are diagnosed with life-threatening illness can benefit from hospice and palliative care.
Adults with chronic conditions benefit from palliative care (HIV/AIDS, Drug-resistant TB, Congestive heart failure, Cerebrovascular disease, Chronic respiratory diseases, motor neuron diseases) and palliative care for the elderly. Also the WHO Definition of Palliativve Care for children states that palliative care should be provided to children with chronic and life limiting illness, not only those who are dying.
Palliative Care is included for patients who suffer during their treatment, illness, and at end of life. Hospice puts no clock on the length of care.
7. What are the benefits of palliative care?
- Reduces high levels of suffering and distress among patients with serious illness, at any age and at any stage of disease
- Improves communication among patients, families, and health care providers
- Addresses the needs of family caregivers as they cope with and care for a loved one with serious illness
- Reduces unwanted, unnecessary, and painful interventions
- Improves patient and family satisfaction
- Can improve survival
- Improves quality of care while reducing cost
- Allows patients to remain comfortable, preventing and relieving pain and suffering, improving their quality of life
- Allows patients to maintain connection to family and friends
- Fosters vitality and independence among patients
- Palliative care reduces the length of stay in hospital so reducing costs and freeing up bed space
8. What are myths about palliative care/hospice care?
Myth: I’ve given up.
Fact: Palliative care and hospice is not about giving up. It’s about living as fully as possible with your condition. You can have palliative care while you are undergoing treatments that may cure or reverse the effects of your illness. In fact, palliative care can help you cope with aggressive treatments by getting your pain and symptoms under control to help you fight the disease.
Myth: Can I become addicted to my pain mediacation?
Fact: Addiction to medication prescribed for pain relief is a common fear but does not frequently occur. Palliative doctors are experts in preventing problems and side effects of strong pain medications. They also can help patients with addictions get pain relief.
Myth: Can pain medicine hasten my death?
Fact: Appropriately prescribed medicine will not hasten death. Your palliative doctor has the expertise to devise a medication plan that makes you comfortable and is safe.
Myth: Does receiving palliative care mean the patient is dying?
Fact: No. The principal aim of palliative care is to control pain and other symptoms so that the patient can remain as comfortable and enjoy a good quality of life as much as their illness will let them. Affirms life and regards death as a normal process.Neither hastens nor postpones death.
Myth: Palliative care is just for seniors.
Fact: Palliative care is provided to people of ALL ages from infancy to adulthood. Adults also die in their prime, and we need to make sure that them & their families are properly supported and prepared for end of life, no matter their age.
Myth: I can only receive palliative care in a hospital.
Fact: Palliative care services are offered wherever the patient is. It can be in many places, at home, at work, in hospitals, correctional services, doctors’rooms, primary healthcare clinics, at school, on the road side, at care facilities & hospice inpatient units.
9. What is an advance directive or living will?
These phrases have the same meaning and involves the process of discussing and documenting a person’s wishes for care in the event of their not being able to communicate this in the future.The value of an Advance Directive is to guide medical and healthcare decisions. The importance of the Advance Directive is that the person drawing up this document in discussion with family and healthcare providers indicates their preferences for care while they are able to discuss these preferences. This will assist families and health care professionals to make decisions relating to a person’s care.
There have been recommendations made, to change the law to allow an Advance Directive (also known as an Enduring Power of Attorney) which carries on even when a person becomes mentally unable to make decisions any longer. But currently it is not possible to go to Court to enforce a Living Will or Advance Directive.
10. Who pays for the hospice service?
If the patient is on medical aid we do claim from the medical aid. Most hospice programs won’t turn anyone away, and programs cover patients through donations from the community.