Hospice vs Palliative Care at Home – which is best for me?
If you’re facing a terminal diagnosis it may feel like there is very little that is within your control. You may feel like you’re receiving advice and information from all sides. But there is one decision that very much comes down to your wishes and it’s perhaps the most important of all. Where do you want to spend the time you have left, and what type of care would you like to receive?
In this article, we’ll offer some food for thought based on our experience with live-in palliative care and the thoughts and feelings of those we’ve worked with in the past. Of course this will never be an easy choice. But the final decision comes down to you and your loved ones and whatever feels like the right thing in your situation.
What do we mean by palliative care?
Palliative, or end of life, care comes into play when there are no curative treatment options left, or your illness has progressed to the point that your body is no longer responding to treatment. It is incredibly difficult to hear the words terminal illness and can feel like all hope is gone. But the opportunity to spend precious moments with loved ones should not be overlooked, and sensitively managed palliative care can allow for and encourage this.
The goal of a palliative care team is to help you get the highest quality of life in your last days, and to give you a dignified death. Whether you choose to move to a hospice during your final weeks and months, or whether you would rather spend the time you have left receiving end of life care at home, your palliative care provider should ask you about your wishes and preferences and work with you to plan your care accordingly.
Why choose hospice care?
Unfortunately, we rarely visit hospices unless we ourselves need them, or we’re visiting family or friends who are receiving nursing care there. This means many of us are unaware of exactly how comforting and calming they can be. They are not sterile or clinical-feeling like a hospital and are instead intentionally designed to promote peace and tranquility.
The goal of a hospice is to provide care for people from the point at which their illness is recognised as terminal to the end of their life, however long that may be. For some people with advanced cancer, pulmonary disease or a life-limiting illness, it might be that a short period of respite care is enough, punctuated by periods of time at home, so long as they are able to remain comfortable. For others the hospice stay may be longer term. Either way, hospices go out of their way to feel more like a home than a hospital.
A hospice will take a holistic approach to your care, with an inter-disciplinary palliative care team of professionals and volunteers working to keep you comfortable and pain-free. And they’ll work closely with your loved ones too, offering ongoing bereavement counselling and spiritual guidance that fits with their religious beliefs if they so wish.
A palliative care specialist from within the hospice team will be available at all times to help with the management of pain and other symptoms. And should you have any questions about your illness and how it is likely to progress, or should your loved ones have any questions about how best to support you, your hospice team will be happy to help.
While the term ‘quality of life’ may not seem to be a natural fit here, hospice care centres on offering symptom relief, access to complementary therapies and emotional support. That way, that no matter your life expectancy or individual circumstances, you can make the most of the time you have left.
Why choose palliative care at home?
The decision to opt for end of life care at home is one that’s wrought with emotion. For some, there is a nervousness about being away from the care of healthcare professionals, in case of infection or symptoms that need urgent medical treatment.
For others, the idea of dying in a place that their family will continue to live can be too much to bear. Your feelings on this may be hard to unpack, and will depend on your age and remaining family members, including children, who will continue to live in the house. This may require an honest conversation about how both you and your partner feel to understand the best course of action to take.
But there are many benefits to receiving palliative care at home, too. Returning to somewhere that feels safe and inviting when you’re discharged from hospital, or at the point you’ve exhausted all active treatment, can feel wonderfully comforting.
Being in familiar surroundings can have benefits in terms of not just mental health but your ability to relax and remember the better times. Being at home offers the opportunity to be surrounded by family and friends if you so wish, and it gives you the flexibility to do as much or as little as you are able to in terms of getting back to some semblance of normality.
Considering live-in palliative care
If you do want to remain in familiar surroundings, you might be worried about being a burden to loved ones. But if you opt for end of life care at home, a live-in carer can take the pressure off of family members by taking control of medications, carrying out many necessary personal care tasks and even household chores to make daily life easier.
While our Promedica24 care team are not medically trained to carry out task such as giving injections or administering medical care, we can arrange for district nurses to come in and do this as part of the care plan. Your live-in carer will be experienced in providing reassuring and supportive care and helping to relieve physical symptoms as well as supporting you with daily activities.
No choice is right or wrong, it simply comes down to the way you feel, the things you believe to be important and the decision that you feel is the right one to make. Of course talk to your friends and family and other healthcare professionals and take professional advice where appropriate. But in the end, it is up to you.
The importance of personal choice in palliative care options
And remember nothing is set in stone. It’s quite common for those who choose hospice care to take a break and return home for short periods if their condition stabilises and they feel well enough.
And vice versa, if you opt for palliative care at home but feel a short period of residential respite care would benefit you and your family caregivers, you can always contact your local hospice to see what they have available.
There is no right or wrong answer for how to deal with a terminal illness. Health care decision are yours to make, based on what quality of life means to you.
If you would like to talk about the option of palliative care at home, call 0800 086 8686 for a FREE no obligation conversation with our Care Consultants or to find out more about how we can help.
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