Q. What is palliative medicine?
A. Palliative medicine is a medical subspecialty provided by doctors who offer palliative care for people who are seriously ill. Palliative care improves quality of life for people of any age and at any stage in a serious illness, whether that illness is curable, chronic, or life-threatening.
Q. What's the difference between palliative care and hospice care?
A. Palliative care is whole-person care that relieves symptoms of a disease or disorder, whether or not it can be cured. Hospice is a specific type of palliative care for people who likely have 6 months or less to live. In other words, hospice care is always palliative, but not all palliative care is hospice care.
Q. Who provides palliative care?
A. Palliative care is provided by an interdisciplinary team that may include a doctor who specializes in palliative medicine, a nurse, pharmacist, social worker, dietitian, and volunteers.
Q. What does a palliative doctor do that's different from what my other doctors do?
A. Your other doctors focus on your general health or treating your disease or condition. Palliative doctors concentrate on preventing and alleviating suffering, improving your quality of life, and helping you and your loved ones cope with the stress and burden of your illness.
Q. Shouldn't all my doctors be concerned with alleviating my suffering and improving my quality of life?
A. Yes, of course. But palliative doctors have special training and expertise in pain management and symptom control, and specialize in helping patients and their families cope with the many burdens of a serious illness, from the side effects of a medical treatment to caregiver stress to fears about the future. Palliative doctors can assist you with difficult medical decisions, helping you weigh the pros and cons of various treatments.
Q. If I receive palliative or hospice care, will I still be able to see my personal doctor?
A. Absolutely. Your palliative doctor coordinates care with your other doctors and helps you navigate the often-complex healthcare system.
Q. Is it true that once you enter a hospice program, you must stay in hospice care until you die?
A. No. Insurers and Medicaid agencies will provide coverage for hospice care if your doctors determine you likely have 6 months (in some cases a year) or less to live if your illness follows its normal course. However, it is your own choice to enter or leave hospice care. If your illness improves or you wish to seek curative treatment, you may leave hospice care, returning if and when you choose to.
Q. Is hospice just for the last few days or weeks of life?
A. You are eligible for hospice care if you likely have 6 months or less to live (some insurers or state Medicaid agencies cover hospice for a full year). Unfortunately, most people don't receive hospice care until the final weeks or even days of life, possibly missing out on months of helpful care and quality time.
Q. If I agree to palliative care, does that mean I'm "giving up?"
A. Not at all. The goal of palliative care is to make you comfortable and help you achieve the best possible quality of life. 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.
Q. How can I find palliative care?
A. Palliative care can be provided at a hospital, a nursing home, an assisted-living facility, or at home. There are a number of ways to find a doctor who specializes in palliative medicine, including asking your personal doctor to refer you to a palliative doctor or asking your local hospital if they have a palliative specialist.
Q. Could I become addicted to the medication used for my pain and symptoms?
A. 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.
Q. Could taking pain medicine hasten my death?
A. 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.
Q. How do I know that I'm receiving the most beneficial or appropriate treatment?
A. Palliative doctors are concerned about you as a whole person—not just the part of you that is sick. They understand that people with serious illnesses can be frightened and unsure of themselves when making medical decisions. They also understand that there is not always one right or wrong answer and that your needs and wishes may change over time. Palliative doctors consider all of this when they help you develop your treatment plan.
Q. Does insurance cover palliative care or hospice?
A. Many private insurance companies and health maintenance organizations (HMOs) offer palliative care and hospice benefits. Medicare (mostly for people 65 and older) offers hospice benefits, and the extra Medicare plan (Part B) offers some palliative care benefits. Medicaid coverage of hospice and palliative care for people of limited incomes varies by state.