❦ WHAT IS HOSPICE PALLIATIVE CARE? Hospice palliative care is whole-person care that aims to relieve suffering and improve the quality of living and dying. It addresses physical, psychological, social, spiritual and practical issues, and associated expectations, needs, hopes and fears. Remember, hospice care, commonly referred to as end-of-life care, is only a part of palliative care. Hospice palliative care helps people, who have been diagnosed with a terminal illness, live out their remaining time in comfort and dignity. It is helpful not only when a person is approaching death, but also at earlier stages of an illness. It can also help families meet the challenges they face when a loved one’s illness cannot be cured. When facing the threat of death, you have to make a painful transition, from thinking of yourself as “somebody who might die”, to “someone who will die”. The transition consists of many stages and it is difficult no matter
what your age and the nature of your illness. Phases include: • The beginning, or early phase as you face the threat of death • An illness phase, in which your pattern of living becomes altered by physical decline • The final phase, in which you are approaching death
The image below illustrates the transition from the beginning phase, to the final phase and beyond. It has been prepared by the CHPCA and adopted across Canada to help people understand the terminal illness progression.
CHPCA Model for the Role of Hospice Palliative Care During Illness
Therapy to modify disease
Focus of Care
Hospice Palliative Care Therapy to relieve suffering and/ or improve quality of life
Presentation/ Diagnosis
Patient’s Death
Time
Advanced Life-Threatening
Illness
Bereavement
Acute
Chronic
End-Of-Life Care
Starting on the left, palliative care is introduced early, when a diagnosis of terminal illness is made. Treatment to modify the original disease is often provided hand-in-hand with palliative care. As you travel across the im- age, you see that less and less disease treatments are provided, while more and more hospice palliative care is provided, right to end-of-life care. At the far right of the illustration, you see Bereavement, which is grief support provided to families and others, after a person’s death. ❦ WHAT IS AN INTEGRATED PALLIATIVE APPROACH TO CARE? In urban centres, palliative care is a specialty. The difference in rural communities is that palliative care is a part of a health care team’s every day practice (nurses, doctors, psychologists, occupational & physical therapists etc.). An integrated palliative approach makes key aspects of palliative care available to individuals and families during a terminal illness and in all care settings. (For more, see The Book of Links). “When people have access to hospice palliative care services integrated with their other care, they report fewer symptoms, better quality of life, and greater satisfaction with their care. The health care system reports more appropriate referrals, better use of hospice care, fewer emergency room visits and hospitalizations, and less use of ineffective, intensive interventions in the last days of life.” (CHPCA, The Way Forward, 2015, page 13)
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