3 Big Challenges in Hospice and Palliative Care
Both hospice and palliative care present an enormous number of challenges for clinicians and patients alike. From facilitating difficult conversations to managing grief and emotional distress to the specific nuances of determining what is right for any given patient, the list goes on.
But with so many challenges in hospice and palliative care, there are a few bigger ones that stand out. Through understanding and overcoming these challenges, patients, their loved ones, and clinicians can pave the way to better care with less challenges down the road.
Dr. Timothy Ihrig, Chief Medical Officer at Crossroads Hospice & Palliative Care, weighed in on these challenges and his hopes for, as he says, “transcending the linear algorithmic model of healthcare which does not work for the most vulnerable sickest of the sick.”
1. Combatting Misconceptions
Common misconceptions and the resulting negative public perception surrounding hospice and palliative care can often present a tremendous roadblock in delivering the right level of care at the right time.
When it comes to palliative care, people tend to make the assumption that it is synonymous with hospice care and the end of life. This is true of both consumers and healthcare professionals themselves, Dr. Ihrig says.
“True palliative care is a much broader definition than what has been brought forth over the past decade,” Dr. Ihrig says. “It has been tainted and the conversation biased… There’s a lot of historical bias and ignorance.”
In reality, palliative care is a form of medical treatment that manages the pain, symptoms, and side effects of chronic illness. It is given at all stages of an illness and can be delivered at any age.
“[Palliative care is] truly expert management of any symptoms, both physical and nonphysical,” Dr. Ihrig continued. “So anything from anxiety and emotional pain to diarrhea.”
Dr. Ihrig also comes across many people who believe that palliative care cannot be delivered concurrently with aggressive therapies that are aimed at cure. This is simply untrue. Palliative care can be a very powerful aide throughout the course of the disease.
2. Late Referrals.
A big challenge resulting from some of these common misconceptions of hospice and palliative care is late referrals. One of the most common things that Dr. Ihrig and other Crossroads employees hear from patients and families is: “we wish we had started sooner.”
The reason for that is because if people don’t have a great idea of what’s on the menu, they are going to have a hard time ordering. For example, no one pursuing curative treatment is going elect to receive palliative care if they think that it is signifying the end of their life.
When it comes to hospice – which is reserved for patients with terminal illnesses – people frequently can underestimate the length of time in which they can take advantage of this service. While people assume that hospice is for a patient’s final days, it is actually for those diagnosed with up to six months or less to live.
Patients covered by Medicare, Medicaid, or private insurance are eligible for a range of hospice benefits that includes a highly skilled team of physicians, nurses, hospice aides, social workers, chaplains, bereavement coordinators, and volunteers to help meet every end-of-life need.
Despite all of the help available, palliative and hospice referrals are still often made too late. And that really comes down to patient and physician attitudes, having difficult conversations, and managing expectations.
3. Managing Expectations
“What too frequently doesn’t happen is the discussion about the whys,” Dr. Ihrig says. “You have a disease. Here is the diagnosis. This is what that means from a physiological standpoint. For example, cancer. Here are the statistics. Here are the avenues to pursue clinically... And it doesn’t happen nearly frequently enough in a clinical setting.”
Looking forward, physicians must prioritize having open and truthful conversations about hospice and palliative care with patients and their families as soon as possible. This way, we can begin to combat all of the misconceptions and challenges in hospice and palliative care and provide more timely referrals, and ultimately, better quality of life.
According to Dr. Ihrig, both hospice and palliative care is “a transformation of doing things to patients to doing things with them and for them.”
It takes into consideration how serious diseases progress and interact with each other, what the treatment options are, and what the trajectory of the disease is to enhance the patient’s quality of life by providing expert management of both physical and non-physical symptoms.
Hospice and palliative care is not about waiting to die. Rather, it is about extending and making the most of your time. The sooner patients, families, and other healthcare professionals can understand this, the sooner their quality of life can improve.
To learn more about hospice and palliative care, please contact Crossroads at 1-888-564-3405.
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