Understanding the Difference: Palliative Care vs. End of Life Care

 Hospice Isle of Man are leaders in the provision of palliative and end of life care which provides comfort, support, and improves quality of life for people facing life-limiting illnesses. Examples of these types of conditions could be an advanced type of cancer, a dementia condition like Alzheimer’s, motor neurone disease (MND), advanced heart disease, or another condition which is likely to cause eventual death.

But what does this mean? Do you know your palliative care from your end of life care (did you even know there was such as thing as palliative care?!). While they are related, there's a key distinction between them.

Palliative Care: A holistic approach to improve quality of life

Palliative care is a philosophy of care that focuses on managing symptoms and improving the quality of life for patients (adults and children) and their families who are facing life-limiting (terminal) illness. This supportive care can begin at any stage of a life-limiting illness where there is no life expectancy limit. At Hospice Isle of Man, it is available when no curative treatment is being sought and a patient requires specialist palliative care (which cannot be met by a more appropriate organisation or health care setting).

Palliative care takes a holistic approach, addressing not just physical symptoms like pain and fatigue, but also emotional, social, and spiritual needs. This might involve:

• Symptom management: Medications, therapies, and other interventions to aid patient’s comfort and allow them to fulfil their goals (which may be to take a daily walk to the shop, or go for a catch up with a loved one)
• Psychological support: Helping patients and their loved one’s cope with anxiety, depression, and other emotional challenges.
• Social support: Connecting patients, their families and carers with resources and support systems to help them manage their daily lives.
• Spiritual support: Addressing patients' spiritual beliefs and concerns.

The goal of palliative care is to ensure that life remains meaningful and fulfilling by empowering patients to live as actively as possible, according to their wishes and values throughout their illness.

End-of-Life Care: Comfort and Dignity

End-of-life care is a specialised form of palliative care received in the last 6 – 12 months of life and is focused on optimising a patients quality of life as life nears its end. 

End of life care includes terminal care, focusing on the final 1-2 weeks of life, and the intense terminal phase during the last few days. When a patient is close to the end of life the focus is on symptom management to increase comfort and reduce suffering whilst also encompassing methods to help the person die with dignity and in keeping with their wishes.

Patients and their loved ones will be supported through the transition to end of life care.

End-of-life care might involve similar interventions as palliative care, but with a heightened focus on pain management and ensuring the patient's wishes regarding their final days are respected.  A sip of a favourite tipple may be the most important medicine at this stage, a trip to the beach for the last time might provide greater comfort than medication adjustment or simply knowing that a beloved pet is being taken care of can bring a feeling of peace.

Advanced care planning is essential as it encourages individuals to document their healthcare needs and wishes for when they can no longer communicate. It goes beyond just stating preferences for medical treatments; it encompasses values, goals, and priorities for care at the end of life.

End of life care focuses on:

• Pain Management: ensuring the patient is pain-free and comfortable
• Symptom Control: managing other distressing symptoms such as nausea and shortness of breath
• Discussing end-of-life medical preferences: Conversations about pain management, life support measures, and preferred place of care.
• Providing emotional and spiritual support: Facilitating open communication, addressing spiritual needs and helping patients and families prepare for death.
• Coordinating care: Ensuring seamless communication and collaboration among different healthcare providers such as staff in a hospital, community nurses, healthcare assistants or hospice staff, as well as social care staff and chaplains.
• Grief and Bereavement support: supporting loved ones by facilitating the grieving process, reducing feelings of isolation and loneliness and enhancing coping skills and resilience.

Many associate end of life care with the ‘Hospice building’ but treatment location remains in line with patient wishes where practicable and that includes at home, in hospital, a care or nursing home as well as in Hospice.

In Conclusion

Palliative care offers a broader support system throughout a life-limiting illness to allow people to live with richness and meaning, while end of life care focuses on the final stage of life, a critical and equally important chapter of life.  Both specialisations aim to improve a patient's quality of life and ensure a dignified and comfortable death.