The difference between palliative care and hospice care programs
End-of-life care becomes an issue at some point for elderly patients. Discuss the difference between palliative care and hospice care programs. Discuss what you can do as a nurse to support your patients regarding end-of-life care in accordance with their wishes. Explain the use of advance directives versus Physician Order for Life Sustaining Treatment (POLST) and their legal implications when providing care for elderly patients.
Supporting Patients' End-of-Life Wishes as a Nurse
As a nurse, you can support your patients' end-of-life wishes by:
- Active Listening:
- Encourage open communication with patients and their families.
- Actively listen to their concerns, fears, and hopes.
- Respectful Care:
- Treat patients with dignity and compassion.
- Respect their cultural and spiritual beliefs.
- Pain Management:
- Administer pain medication effectively and promptly.
- Monitor for side effects and adjust medications as needed.
- Emotional Support:
- Provide emotional support to both patients and their families.
- Offer comfort and reassurance.
- Advocacy:
- Advocate for your patient's needs and wishes.
- Work with the healthcare team to ensure optimal care.
- End-of-Life Planning:
- Encourage patients and families to discuss end-of-life wishes.
- Assist with completing advance directives or POLST forms.
- Advance Directives:
- Legal documents that outline a person's wishes for medical treatment in case they become unable to make decisions for themselves.
- Often include a living will and a healthcare power of attorney.
- POLST (Physician Orders for Life-Sustaining Treatment):
- A medical order that specifies a patient's wishes for life-sustaining treatments, such as CPR, intubation, and artificial feeding.
- More specific than an advance directive and is a medical order that should be carried out by healthcare providers.
- Advance Directives: These documents can provide guidance to healthcare providers about a patient's wishes, but they are not legally binding.
- POLST: These orders are legally binding and must be followed by healthcare providers.
Palliative Care vs. Hospice Care
Palliative care and hospice care are both approaches to caring for individuals with serious illnesses, but they differ in their focus and timing.
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Palliative Care:
- Focus: Provides relief from symptoms and stress of a serious illness.
- Timing: Can begin at any stage of illness, often alongside curative treatment.
- Goal: Improve quality of life for both the patient and family.
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Hospice Care:
- Focus: Provides comfort and support for patients with a terminal illness.
- Timing: Begins when curative treatment stops and focuses on comfort and quality of life.