Palliative，Hospice and HomeCare

Palliative and Hospice care are also known as comfort care and end-of-life care.

What is palliative and hospice care?

Both palliative care and hospice care are medical programmes to help improve the quality of life for patients living with a severe illness, like heart failure, cancer, dementia, Parkinson’s disease, kidney failure, HIV/AIDS, and many others.

On top of medical care for the patient, this approach is also extended to the patient’s families because it focuses on providing social, emotional, and practical support.

The idea is to offer comprehensive comfort care and support for the patient and family in the form of medication, day-to-day care, equipment, bereavement counselling, and symptom treatment.

Who is part of the palliative and hospice care team?

The team typically consists of specialist doctors and nurses, social workers, psychologists, dieticians, and counselors who work together with the patient, family, and primary doctors to monitor on-going comfort care.

What is the difference between the two?

Palliative care mainly focuses on preventing and alleviating pain and suffering by identifying, assessing, and treating the symptoms.

This can be done at any stage of the illness, even at diagnosis, in conjunction with other treatments that are being conducted to prolong life, including chemotherapy and radiation therapy.

However, when the palliative care team finds that the on-going treatment is no longer helping, palliative care could transit into hospice care.

In hospice care, the focus is no longer to cure the illness but on comfort, so any form of curative or life-prolonging treatment will be stopped.

This happens when the doctor believes that a terminally-ill patient's lifespan is limited.

Who is it for?

Anyone with a serious, long-term illness is eligible to receive palliative care, while hospice care is mainly for patients with less time to live.

As morbid as it sounds, any patient that starts hospice care understand that his or her ailment is no longer responding to efforts to cure. Since extensive life-prolonging treatment is halted, patients can focus on making the most out of the time they have left without having to worry about the adverse side effects of aggressive medical treatments.

The patients can also concentrate on the emotional and practical aspects now that the End is near.

Where is this offered?

It is most common to find palliative care provided in hospitals, nursing homes, outpatient palliative care facilities. Of course, it can also be done in the patient’s home if that is the preferred choice.

The need for palliative care will rise as Malaysia will soon become an ageing nation over the next decade.

In a recent article about Palliative Care, Dr Richard Lim Boon Leong (national adviser for palliative medicine to the Minitsry of Health) estimated that roughly 130,000 patients a year require some form of palliative care and the number is projected to increase. He highlighted that there is a “misconception about palliative care being about death and dying, when it is in fact about life and living.” He and other pioneers of palliative medicine,such as Hospis Malaysia CEO Dr Ednin Hamzah hope to change the general perception that palliative care is only for the terminal cases. “If palliative care is introduced early enough, not only does it improve the patient’s symptoms and overall quality of life, it actually extends survival rates in terms of months,” says Dr Ednin.

What about home care?

The goal of home care is less about end-of-life care and more to help a patient to recover, regain independence, become self-sufficient, and remain in a stable condition.

Comprise of nurses, therapists and caregivers, they help with activities of daily living such as companionship, showering, meal preparation and medication reminder. They can also provide nursing procedures such as changing feeding tubes to injections and wound care. Physiotherapy, occupational therapy, and speech therapy can also be arranged in the comfort of your homes.

More resources at:

1. Global Hospice Palliative Care Network
2. Hospice Malaysia
3. Palliative Care
4. National Cancer Society