Transitioning From Palliative Care to Hospice

When someone is diagnosed with a terminal illness, treating and managing their symptoms becomes a top priority. A large part of successfully caring for someone with a terminal illness is understanding how palliative and hospice care play a role in treatment and what the transition from palliative to hospice entails.

Hospice and palliative care provide similar goals of providing pain management and symptom relief. Palliative care can be provided to anyone with any chronic illness, at any time without restriction to disease or prognosis. Hospice care involves palliative care, but there is no intent to cure the patient and that a patient has less than six months to live if the disease follows its usual course. These are two very different programs, yet they share the same goals and beliefs.


What is palliative care?

Palliative care is specialized medical treatment specifically for people who have a serious chronic illness. While that person may have a specialist dedicated to treating or curing their illness, palliative care is focused on providing pain relief and managing the symptoms of the illness. 

Palliative care is provided by a team of physicians, nurses, therapists, social workers, chaplains, pharmacists and other professionals who work alongside a primary care physician and referring specialists to provide an extra layer of support. 

Palliative care helps to improve the quality of life for patients and families and supports them through important healthcare decisions along the way. 

A common misconception about palliative care is that it means giving up. However, palliative care can be received as soon as someone is diagnosed with a serious illness and it can be provided alongside curative treatments. That means that someone may eventually stop needing palliative care because their curative treatment worked! 

On the flip side, if a patient’s condition worsens or a cure is no longer an option, it may be time to transition to hospice care. 

What is hospice care?

There may come a point when an illness isn’t curable or you and your family member decide that ongoing curative treatment is not worth any side effects, pain or suffering. This is when hospice can step in.

Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but any attempts to cure the person’s illness are stopped. Typically, hospice is provided for a person with a prognosis of six months to live or less. Because hospice is an approach to care, it can be offered at home or in a facility like our Patient Care Center in Madeira.

Hospice should not be thought of as a death sentence. Hospice focuses on helping patients live their remaining days peacefully and comfortably, giving life back to their days.

Too often, patients transition to hospice too late, limiting the amount of comfort that hospice providers can offer support. That’s why it’s important to understand the transition from palliative care to hospice.

Transitions in care

Critical turning points in the course of a patient’s illness often signal the need to address palliative and curative care decisions and consider transition to hospice.

It’s confusing to know if hospice is right for your loved one when they’re diagnosed with an incurable illness. To help determine if it’s time to call hospice, keep an eye out for the following signs:

  • Frequent hospitalizations or trips to the ER
  • Reduced desire to eat, leading to significant weight loss and changes in body composition
  • An increase in falls
  • Changes to their mental abilities
  • Skin tears, infections and other signs of deteriorating health
  • Uncontrolled pain, shortness of breath, nausea or vomiting
  • Decreasing alertness, withdrawal and increased sleeping or mental confusion
  • Decline in their ability to perform daily tasks including eating, getting dressed, walking or using the bathroom

Your palliative care team may also make a recommendation to consider hospice. If you think your loved one may benefit from hospice care, you can talk to their doctor and your palliative care team (if you have one) for their opinions. Ultimately though, any individual can reach out to a hospice provider without a doctor referral. You can read more here about how to select a hospice provider. 

Understanding the process

Once you’ve made the decision to pursue hospice care, a hospice staff member will set up a meeting with you to ask questions and confirm if hospice is the right choice. If so, the hospice team will begin to work with your family, either in-home or in a care facility, depending on you and your loved one’s choice.

If your family member has services from a palliative care agency, they will phase out their services as the hospice team takes over.

If you opted for in-home care, you may have to make some changes to the home such as moving furniture to make room for equipment. Under routine hospice care, patients receive regular visits from members of our care team based on their specific needs.

With in-home care, a member of the hospice team will come by the house several times per week to check in and make sure the patient is comfortable and experiencing relief from pain and other symptoms.

If you choose to have care administered in a facility, your loved one will be assigned a room in the hospice’s care facility or will remain in their space at their existing healthcare facility (i.e., nursing home, assisted living center, etc). They will then receive care from the hospice team.

The most important part of transitioning from palliative to hospice care, or even starting palliative care after a diagnosis, is understanding your options. Start discussions early, not just when there is a crisis. Talk to your loved one and listen to their wishes and concerns at every stage of the process and make sure you have a clear discussion with their doctors, too. With a professional as a trusted and responsive guide, any transition in care can be more successful for everyone involved.

Find out more about Hospice of Southwest Ohio

Hospice of Southwest Ohio is dedicated to enhancing the quality of life during a patient’s final months and days. Rather than viewing hospice as scary or troubling, it can be viewed as a natural way for patients to pass away with dignity and the loving support of family, friends and an interdisciplinary care team that helps them experience a more peaceful and comfortable death.

We are happy to answer any questions you may have about end-of-life care. Hospice of Southwest Ohio offers hospice, palliative and in-home primary care in and around the greater Cincinnati area in Clermont County, Butler County, Warren County and Hamilton County. Call today at (513) 770-0820.

Find out more about CareBridge Primary and Palliative Care

CareBridge Primary and Palliative Care offers services provided by a team of dedicated physicians, nurse practitioners, social workers and chaplains who are there to help relieve pain and suffering associated with any illness, at any time.

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