What is palliative care and how does it differ from hospice?

The term “palliative care” has been bandied about quite a bit as of late. But what does it mean? On Monday’s St. Louis on the Air, three people joined host Don Marsh to discuss what palliative care means and how it differs from hospice care.

Joining the program to discuss palliative care:

• Maria Dans, MD, clinical director of Palliative Care Services at Washington University School of Medicine
• Patrick White, MD, medical director of BJC Hospice
• Barbara Westland, RN, director of BJC Hospice

What is palliative care, exactly?

“It is something that builds on traditional medical care,” said Dans. “There is the use of an interdisciplinary team. We’ve got a physician, nurse, social worker, chaplain and we’re working together to help patients and families. Most of these people have life-limiting, serious illnesses. Obviously, there are a number of challenges that go along with that. Not simply physical symptoms but also spiritual, psycho-social, financial issues. Palliative care is not prognosis-limited. As long as you have a serious illness, our team will be happy to see you.”

What is the difference between palliative care and hospice?

“The practical difference between palliative care and hospice is that palliative care tends to be provided on an in-patient basis in acute-care hospitals,” Dans said. “Most places that have a palliative care program have an in-patient consultative program as opposed to hospice which is provided in a long-term care facility or in people’s homes.”

“Our focus with hospice care is for patients with a life-limiting illness, we’re talking about the last 6 months of life, and what we want to do is to support them to achieve their goals and needs,” said White. “We help to keep patients in their home and keep the vast majority of care there while we’re helping to treat their symptoms. We think of palliative care as early-on, starting out.”

“Hospice is palliative care,” said Westland. “But palliative care is not always hospice. Palliative care is earlier in the disease trajectory.”

How long has palliative care been in practice?

Since 2006, officially.

How are social workers involved?

“Our social worker spends a lot of time talking about advanced care planning but also counseling, listening, helping people clarify medical illnesses,” said Dans. “We wouldn’t be able to do what we do without her.”

“In terms of hospice, the social worker role is similar to the palliative care role,” Westland said. “One of the things the social workers help with is to really bring the family together and helping with any conflict that may be occurring in supporting and offering guidance to the family. This is a process we only do once so to have the support of people who have worked in the field means a tremendous amount to our families.”

How old are palliative care patients?

“We actually take care of children as young as infants and newborns to, I think my oldest is 106 years old,” said White. “We have quite a spectrum of ages.”

Have more questions about palliative care? Listen to the segment here:

St. Louis on the Air brings you the stories of St. Louis and the people who live, work and create in our region. St. Louis on the Air host Don Marsh and producers Mary Edwards, Alex Heuer and Kelly Moffitt give you the information you need