Hospice and Palliative Care

What is Palliative Care?

Hospice of Texas is a comprehensive program that includes palliative care to help manage symptoms (such as pain) at the end of life. This kind of care focuses on improving the quality of life when aggressive treatment is no longer realistic. Our doctors and health care workers involved with Hospice of Texas help you identify your treatment choices, identify goals for the end of your life, and emotional and spiritual resources if you wish to pursue them.

Hospice of Texas treats the entire family by supporting the loved ones involved in your care by offering service such as home visits, breaks for caregivers (respite care) and grief counseling. `

Once you start our hospice program, you agree to end all life-prolonging treatments and to focus completely on your comfort, quality of life, and symptom relief. However, the decision to forego other treatment does not have to be permanent. Although you usually must leave hospice care to pursue other treatments, you may be re-admitted at a later time.

Relieving your physical symptoms

Palliative care at the end of life attempts to control many of the symptoms associated with serious illness and the dying process. You may decide that treatments designed to prolong your life are more likely to add pain and will not prolong your life in a meaningful way.

If you choose to focus completely on palliative care, your physician will concentrate on relieving your symptoms such as pain, nausea, shortness of breath, fever, vomiting, and loss of appetite. In order to help keep you comfortable, your physician will ask you to describe your symptoms. Questions may include:

• Are you experiencing pain, nausea, or both? Do you have more than one pain? Is your pain sharp or dull? What other symptoms are you experiencing?
• Where do you feel pain or other symptoms? For example, are you having pain in you chest or throughout your body?
• When do your symptoms usually occur? For example, if you are having shortness of breath, does it develop after activity or is it constant?
• What worsens your symptoms? Activity may aggravate your pain just as sitting in one position for a long period of time would.
• What helps your symptoms? Rest or taking your pain medication as instructed.

Describe your symptoms as clearly as possible. You may find it helpful to keep a record or chart of your symptoms so that you can discuss them with your physician.

Estimating your prognosis

An important aspect in choosing your medical care at the end of life involves making a reasonable attempt to estimate your prognosis, the amount of time you have left to live. Your prognosis will help you to evaluate the appropriateness of certain medical treatments. For example, if your physician feels you have several months to years to live, certain medical therapies may help you maintain comfort and improve the quality of your remaining days. On the other hand, if you are expected to only live for a few weeks, certain medical treatments, such as surgery, may cause more pain and side effects than you are willing to endure.

Understanding your prognosis is important for you and your family prepare for dying. Having a sense of how much time you have to live may help you to review your life, your accomplishments, and your regrets. It may also help you to focus on saying goodbye to your family and to nurture or complete relationships.

Although sometimes it is difficult for physicians to estimate prognosis, you should expect clear and sensitive answers to your questions. It may be helpful to see another physician for a second medical opinion when prognosis is not clear.

Identifying your treatment goals

As the end of life nears, your physician will help you identify your treatment goals and make sure your medical care fits in with your preferences. This communication may help you decide whether you want to continue with or stop receiving aggressive treatment. For example, while talking about your treatment options with your physician, you may discover that your only wish is to keep your pain at a controlled level. You may identify several goals such as, staying active as long as possible and living to see your first grandchild being born, that point more toward pursuing or continuing with life-prolonging treatments.

If you are admitted to Hospice of Texas, our services are easily accessed because they offered or addressed as part of the program. Also, additional services are available such as grief and spiritual counseling for you and your family members.