Palliate means to relieve. Palliative care can enhance cancer treatment by improving quality of life for patients with life-limiting illnesses and for their families. Pain Medicine and Palliative Care Program services at Huntsman Cancer Institute (HCI) include the following:

• Management of pain and symptoms of cancer and its treatments
• Mental health and spiritual support
• Assistance with medical decision making and advance care planning
• Holistic medicine

When is palliative care needed?

Palliative care can be integrated with cancer treatment any time physical or psychological symptoms interfere with quality of life. HCI provides expert care for patients from the time of cancer diagnosis throughout the course of illness. We also care for patients who have survived cancer but may experience long-term side effects.

How does palliative care differ from hospice?

Insurance companies usually define hospice as a service for patients who will probably live six months or less. It is usually limited to patients who are no longer receiving active cancer treatment. Palliative care is available to all patients and may take place at any time during the course of treatment.

When is the best time to choose hospice?

Doctors usually recommend hospice care to enhance quality of life when a cure is not possible or when conventional treatments have become too burdensome for the patient and family.

The focus of care shifts from attempts to treat and cure the underlying disease to providing intensive care for pain and symptom management and family support.

The six-month time frame that is often given is not absolute. Patients often live longer than their expected prognosis with good quality of life and symptom control.

Where is hospice care provided?

Hospice care usually takes place in the patient's home with the support of nurses, home health aides, social workers, and other providers. For limited amounts of time, Medicare allows it to be provided in extended care or skilled nursing facilities. Some programs have inpatient hospice facilities that provide short-term care for closer attention to symptom management or to provide a break for caregivers.

The palliative care team includes physicians, nurses, social workers, chaplains, and consultants from many other areas of health care such as physical therapy and nutrition.

Who oversees hospice care?

When patients activate their hospice benefit, they will be asked to choose a primary care provider. This is usually the medical director of the hospice.

Patients may choose to have their own primary care physician, oncologist, or palliative care physician supervise treatment while receiving hospice services. The hospice agency must be willing to honor this arrangement and consult with the physician the patient has selected. HCI providers supervise care in the home setting. If desired by the patient and family, full responsibility for care may be assumed by the hospice agency.

What about medications and treatments?

In hospice care, the hospice team provides all medications and treatments. However, individual circumstances vary. Sometimes social work, case management, or discharge planning staff will assist patients in coordinating other arrangements.

Can I continue cancer treatment in hospice care?

Some therapies such as radiotherapy and chemotherapy may be used in hospice when the primary purpose is to relieve the symptoms caused by cancer. This usually requires negotiation with the primary insurance provider and may temporarily interrupt the hospice benefit. These treatments are reviewed and arranged on an individual basis.

What should patients consider when choosing a hospice agency?

The first step in choosing a hospice agency is determining what hospice services are covered by the patient's insurance provider. HCI's Patient and Family Support team and case management staff can assist patients in determining what resources are available.

It is a good idea to talk with representatives of several services to understand what they offer. There are some good questions to ask:

• What training do the medical director and nursing staff have?
• Is the staff certified in palliative care and hospice?
• How long has the agency been established and operating in the community?
• How long have staff members been working with the agency?
• Is the staff interested in the patient?s personal goals and care needs?
• Will a nurse be available by phone at all times to consult as needs change?
• Is the doctor available for consultation at all times?
• Are intepretation services available for non-English speaking patients?

Our goal is to provide excellent palliative care and helpful information for you and your family. Please contact us if we may provide assistance. Patients in the hospital may request a referral from the attending physician.

HCI Pain Medicine and Palliative Care
801-585-0157
www.huntsmancancer.org
Improving Quality of Life for Cancer Patients and Families

For more patient education information, call 1-888-424-2100 toll free or go to www.hopeguide.org . Produced by Huntsman Cancer Institute. Approved by PESC August 2009. Review Date August 2011.

Published by:
Huntsman Cancer Institute

Related Cancer Topics:
Advanced Cancer , HCI Programs , Hospice , Palliative Care , Patient and Family Coping

Last Reviewed: November 18, 2009