Dame Cicely Saunders, who founded the first modern hospice in 1967, came up with the idea of a special place that combined medical care with dignity, comfort and love.
More than a half-century later, hospice is still intended to provide compassionate care for patients of any age in the final phases of life.
But end-of-life care is often confused with palliative medicine, which aims to improve quality of life for people living with a serious illness.
While they have much in common, the two services have important differences.
Timing is everything
Hospice care is initiated after treatments stop and is traditionally reserved for patients expected to live for less than six months.
It often allows the patient to remain in the comfort of their home while receiving regular visits from a dedicated interdisciplinary team that specializes in end-of-life care.
Palliative medicine is available as early as the moment of a diagnosis and has no set duration. Patients can move in and out of this service as their health fluctuates.
Palliative medicine can be administered on an inpatient or outpatient basis and is conducted alongside the care already provided by a primary care physician and any other specialists involved in the patient’s care.
Roxanne Miller, LCSW, a licensed clinical social worker and manager of Palliative Care for Baptist Health, said hospices offer four core services: physician and nursing services, medical social services and counseling (including bereavement).
“It’s is very rewarding to meet with patients and their families to identify which resource best supports their care goals,” added Miller, who is responsible for the daily operations of the inpatient palliative care consult service at Baptist Health’s four adult hospitals.
“We often help patients with referrals to outpatient palliative services or hospice care and regularly assist with patients’ end-of-life wishes, as part of our advance directives discussion.”
Higher levels of care
Hospice care is provided wherever the patient calls home, whether it’s a personal residence, nursing homes or somewhere else. Hospital-based services offer a higher level of care for patients with needs for pain and symptom management. These inpatient facilities are called hospice units or care centers.
Baptist Health, which partners with Community Hospice and Palliative Care, has established inpatient hospice units at three of its five hospitals:
- The Douglas Center for Caring at Baptist Jacksonville
- The Warner Center for Caring at Baptist Nassau
- The Center for Caring at Baptist South
The goal of inpatient hospice units is to help patients feel like they’re in the comfort of their homes.
“Making end-of-life decisions is hard enough on families. When we have the ability to transition patients from one level of care to another in one location, a huge burden is lifted from the family,” said Michael A. Mayo, DHA, FACHE, president and CEO of Baptist Health, who made a personal gift to the Douglas Center for Caring in his father’s memory.
“Navigating from palliative care to hospice care with my father, I personally know the value of having the right care setting and caregivers at the right time," Mayo said.
Regardless of the illness, be it cancer, organ failure, dementia or any number of diseases, hospice and palliative medicine share similar goals:
- Improve quality of life
- Increase overall comfort
- Provide emotional support for the patient and family
- Help the patient make important decisions about their medical treatment
In 2005, Saunders, who’s been called the Florence Nightingale of hospice care, passed away at 87. She spent her final days at the same hospice she envisioned for others: a safe place without suffering where people can die peacefully with dignity, comfort and love.
In addition to three dedicated hospice units, Baptist Health has Palliative Care teams in all of its adult hospitals who collaborate with geriatricians and Spiritual Care chaplains. Talk to your [primary care doctor or treating physician specialist] to determine which type of care is best suited for you or a loved one.