Palliative and hospice care provide similar, but different services for patients and their families that focus on a holistic approach and their quality of life.
Palliative care is a way to help people with serious illnesses feel better physically and emotionally, and it can start at any point in their illness. It works with other types of treatments that aim to cure the illness. By contrast, hospice care is a special kind of palliative care for those with less than six months to live, with a main focus on keeping them comfortable and emotionally-supported during that time.
Here are some important differences between these two kinds of care:
- Aims to reduce pain and suffering in people with serious illnesses.
Read more from the National Hospice and Palliative Care Organization
- Can start at any stage of the illness, including at diagnosis, and can coexist with treatments, regardless of the person’s expected recovery.
- Can take place in various locations, including hospitals, clinics, or even at home.
- The intensity of medical treatment can vary widely, potentially including strong treatments.
- Often covered by health insurance and integrated into regular medical care.
- Primarily for individuals with a short life expectancy, often six months or less and involves a team of experts.
- Main goal is to provide maximum comfort rather than aiming for a cure.
- Usually provided at the patient’s home, in a specialized hospice facility, or in a hospital.
- Typically begins when it becomes clear that treatments are not effective, focusing on the patient’s comfort in their final days or months.
- Emphasizes comfort and symptom management, often discontinuing aggressive treatments.
- Often covered by Medicare, Medicaid, or private insurance for eligible patients.
Both palliative care and hospice care provide comfort and support for patients, one throughout cancer or other illness, and the other as one approaches the end of life. Have a conversation with your doctor to figure out the kind of care that’s right for you and your unique situation, so you can live your best life.
Don’t Wait! Bag It Bag and online resources are able to provide ways to empower patients and their families to ask for these services (palliative and hospice care) to improve the quality of life of patients and their families. Order a Bag and explore our Cancer Resource Center.
If you were diagnosed with a chronic illness such as cancer, heart disease, an autoimmune disease, or diabetes, experiencing a period of sadness, anxiousness, worry, anger, and stress is not uncommon. But if distressing symptoms persist after a couple of weeks, depression could be further complicating your overall health.
Possible signs of depression:
- Persistent sadness, tearfulness, emptiness, anxiousness
- Feeling hopeless, worthless, guilty, or pessimistic
- Irritability, outbursts of anger, frustration
- Feeling helpless
- Restlessness, loss of interest in pleasurable activities
- Lack of energy, fatigue
- Memory issues, difficulty with concentration or decision making
- Sleep disturbances (insomnia, oversleeping)
- Changes in your appetite or weight gain/loss
- Unexplained aches or pains
- Frequent thoughts of self-harm, death or suicide
The good news is that depression is highly treatable, and working with your healthcare team is the place to start on your path to wellness. As with any health condition, the earlier the treatment for depression begins the more effective it is.
Don’t wait for your healthcare provider to bring up the subject. As you prepare for your next appointment, make this one of your top three topics to discuss. Write down your depressive symptoms, how long you have had them, how often, intensity, etc. Be honest and describe their impact on your daily life and those around you.
Bring a complete list of all the medications (and supplements) you take. Also let the doctor know about any personal history of anxiety or depression in yourself or your family. (Remember that everything you share with your healthcare team is private and confidential. It cannot be discussed with others without your permission.)
Your healthcare provider will explore the treatment options with you. Depression is often effectively treated with medication, “talk therapy” (talking one-on-one with a professional), or both. Find what works for you. Be patient as it may take some time to feel better. Research has shown that treating your chronic illness and depression together can help you manage both more effectively and improve your overall quality of life.
Should you find yourself in a crisis, call the NAMI Helpline at 800-950-NAMI or text “NAMI” to 741741
Myth #1: Everyone experiences pain with cancer.
- About half of people with cancer experience pain at some point – but about half don’t.
- Pain management is part of cancer treatment. In most cases pain can be controlled.
- Those with advanced cancer usually experience more pain than someone newly diagnosed.
Learn about the different types of pain, its causes, and how pain can be measured Causes of cancer pain: Pain can be caused by the tumor itself, cancer tests or procedures done, or it can occur as a side effect of treatment (surgery, chemotherapy, immunotherapy, radiation therapy). There can be more than one cause of pain. Some pain ends when treatment ends but some pain can be ongoing and chronic. Types of Pain:
- Acute pain – this type of pain comes on quickly but it does not last long. It can be mild, moderate, or severe.
- Chronic pain -this type of pain can be consistent or it can get worse, lasing a long time. Again, it can be mild, moderate, or severe.
- Breakthrough pain – this type of pain is usually a sudden increase in intense pain that “breaks through” the pain medications being taken to control pain, typically between does. It lasts for a short time. There are medications specifically used to treat this type of pain.
Pain Severity: Everyone experiences pain differently. It’s a good idea to keep a record of your pain to share with your healthcare team. Using one of the customizable logs in section 2 of Bag It’s My Companion Guidebook is an easy way to track your pain. You can use the scale below to assess your pain’s severity and type, noting when, where, how it feels (e.g. “burning,” “stabbing,” “throbbing) and other pertinent details on the form. Make copies to give to your healthcare team at your next appointment. This will help them to determine a pain management plan tailored just for you. Using a scale from “0” to “10”:
- 0 means no pain
- 1 to 3 means mild pain
- 4 to 6 means moderate pain
- 7 to 10 means severe pain
Myth #2: Only opioid medications relieve cancer pain.
- Non-opioid medications may be effective pain relievers depending on the type of pain someone is experiencing.
- Palliative surgery or radiation therapy is sometimes performed to ease symptoms and increase comfort.
- Palliative (supportive care) is care that focuses on relieving the symptoms of cancer, like pain, and other impacts on your physical, emotional, mental and spiritual well-being.
- Physical therapy, exercise, complementary and integrative medicine therapies such as acupuncture, massage and relaxation techniques are possible ways to manage pain without medication.
A personalized pain management plan prescribed by your healthcare team could include one or more of the above treatments to improve your quality of life. It’s important to talk openly with your healthcare team if you are experiencing pain. In addition to describing the pain in detail, let them know how it is impacting your daily life.
Palliative care (supportive care)
Palliative care is not hospice care. The aim of palliative, or supportive, care is to improve quality of life and maintain independence by reducing symptoms, managing pain, and supporting patients and their families. The aim of hospice care is to help the patient approach the end of life with peace, respect, and dignity, and it includes palliative care. Palliative care is an approach to care that addresses the person as a whole, not just their disease. The goal is to prevent or treat, as early as possible, the symptoms and side effects of the disease and its treatment, in addition to any related psychological, social, and spiritual problems. You can receive palliative care at any age and at any stage. Receiving palliative care does not mean that you will no longer receive treatment for the disease. People often receive treatment to slow, stop, or eliminate cancer in addition to treatment to ease discomfort. In fact, research shows that people who receive both types of treatment often have less severe symptoms, a better quality of life, and report they are more satisfied with treatment. Ask your healthcare team about the ways palliative care might be helpful to you and your family.
Additional Resources on Pain
ASCO Answers: Managing Cancer-Related Pain
Cancer Pain Control: Support for People With Cancer
ASCO’s booklet, Palliative Care
Survivorship is such a tenuous concept. Who is a survivor? What’s the measurement stick? Time? Quality of life? Remission? Cancer-free (for the time being)?
Sherri in 2021
The term “survivor” resonates with so many but it just never has felt a right fit to me. I do feel like I survived something….but it might not be exactly the cancer I was diagnosed with almost 20 years ago. That is still hanging around in forms of neuropathy and other nagging long-term and late-effect issues. I still get the heebie jeebies when I go for screening. Lots of self-talk. That doesn’t sound like a true, viable survivor attitude in my head.
What I did survive was learning how to do something extremely difficult and challenging and come out on the other side. Some days are better than others, but it IS on the other side. I survived telling my teenage sons I had cancer when I could barely get the stupid word out. I survived all those disappointing non-reactions and reactions from family, friends and colleagues. I survived my husband growing a beard for some odd reason when I was going bald. No justice in that! I survived throwing up in the chemo room (at lunch time of course – amazing how quickly people can tuck away a sandwich!) I survived the health care system that wasn’t exactly all that helpful on the social/emotional side of things. I survived realizing that my life was not eternal.
Looking for the Humor
And surviving cancer is not without humor. Telling my class of kindergartners and parents that I had cancer was a challenge, especially showing up with 1” hair (a different color of course) sticking up all over my head. And no eyebrows. That I nearly did not survive. I never learned the trick of eyebrow liner. Always ended up with these winging designs that sent me into fits of laughter. I kept telling the kiddos that yes, it really was me. I got a call from the school office after I made my first classroom visit to come “pick up a personal item.” Turned out to be my new breast prosthesis that apparently I did not have the correct knack of using. It had fallen out of my shirt and onto the classroom floor. The kindergarteners were playing Frisbee with it across the room when the principal came in. Took him awhile to figure out just what it was. He had the substitute place it discreetly in a brown bag and take to the front office for “pick up.” I did survive the initial humiliation and then broke out in huge chuckles.
Taking a Leap of Faith
I survived the life-changing challenges of starting a cancer non-profit while continuing to teach. I had absolutely no business experience, just a passion to help educate and make things easier for others. I survived asking for LOTS of help which was not in my comfort zone. Today, almost twenty years later, we have a new executive director leading the way. I am blessed to still be involved in a meaningful way. Still surviving.
Surviving is not without its disappointments. With this work, I have not completely survived feeling so incredibly guilty around others with cancer that have metastatic disease and/or going through cancer treatment for chronic disease….no end in sight. I still struggle when fellow cancer advocates with chronic disease disregard my completed, past treatment thinking I can’t comprehend their chronic situation. That hurts. I don’t understand fully, but I really, really try.
Inspiring Other Advocates
How much of a challenge is it for someone surviving cancer to become an advocate for others in the same space? Tremendous! So I founded an annual leadership conference ten years ago for cancer advocates helping others with all types of cancer in all kinds of capacities (Escape to THRIVE). These advocates are filling gaps in cancer care all over the country. All of them not only surviving but taking that giant leap into helping others through all this. I hesitate to call it a journey…that’s so cliché these days but it is a voyage. We are all travelers in that cancer space. The courage of all these people that have CHOSEN to help others despite the constant reminder of their own cancer! They have taken on the job as advocate and guide. It takes such bravery as they are reminded almost daily of their own experiences. I get such extreme fulfillment from encouraging advocates to keep up their incredibly valuable work and stay well along the way. That’s the tricky part. If you want to keep surviving, you have to be aware of what you are asking the self to do.
Surviving and Moving Forward
I work hard at surviving…meditate as often as I can, sustained exercise like walking, swimming, hiking – some with friends and some solo. I recently learned the term “outgoing introvert.” Sounds like survival to me! I try to say “Enough!” when I need to and remind myself “I am Enough” when I need to.
So in the end, I consider myself not a survivor but surviving…the continual path of struggle and triumph, ease and fear, sadness and humor, hesitation and courage….surviving life, not just cancer.
Sherri and her family supporting Bag It