The moment she says the words “palliative care,” Nishitha Reddy, MD, can often see it written all over a patient’s face: worry.
“They’ll often ask, ‘Am I dying? Is that why you’re seeing me?’” says Dr. Reddy, who specializes in palliative care.
She is quick to set the record straight. Palliative care is for anyone living with a serious illness, whether they’re pursuing curative treatments or facing end-of-life symptoms. And it has a lot to offer.
“When I share everything that palliative care can do outside of end-of-life care, patients and families are often surprised,” says Dr. Reddy. “I’ve had so many people ask why they didn’t meet us sooner!”
> Ask about palliative care for you or a loved one.
The confusion between palliative care and hospice
To reiterate: Palliative care is for anyone living with a serious illness, at any stage — including people who are actively pursuing a cure.
Yet it’s commonly confused with hospice, aka end-of-life care. Why?
For one, both specialties are relatively new. Hospice was introduced in the U.S. in the 1970s. Palliative care was only just recognized as a medical specialty in the U.S. in 2012. As a result, the general public and even many healthcare experts are still learning about these fields.
To add to the confusion, palliative care and hospice do share many similarities — both in the types of illnesses they treat, and in their approach.
The similarities: Whole-person care for serious illness
Serious illnesses — like cancer, heart failure, lung disease and dementia, to name a few — come with unique challenges, which impact just about every aspect of a patient’s and family’s life.
Palliative care and hospice are are both designed to help, although they enter the picture at different times. (More on that below.)
Both specialties offer:
- Medical management to target burdensome symptoms
- Help ensuring a patient’s medical decisions reflect their personal goals
- Compassionate emotional and practical support, both for patients and their loved ones
- Enhanced communication across all of a patient’s existing care teams
“That focus on quality of life, symptom management, and good communication is the same across palliative care and hospice,” says Dr. Reddy. “For both, our goal is to enhance your quality of life. Basically, it’s focusing on how we take care of you as a whole person.”
The difference: Timing
The biggest difference between hospice and palliative care comes down to timing, and where someone is in the course of their illness.
Hospice is for patients who are no longer pursuing curative treatments — either because they are ineffective or burdensome — and instead transitioning to comfort-focused care. It’s intended for the last 6 months of life, though many patients outlive that timeframe.
Palliative care, on the other hand, can support any stage of a serious illness — ideally, beginning right at the moment of diagnosis. It can be provided alongside curative-aimed treatments, and take place in any number of settings, from a clinic or hospital to home or nursing home.
“Palliative really serves all different types of people from all different spectrums of diagnoses,” says Dr. Reddy.
> Read: Hospital, clinic, home: Understanding the settings of palliative care
For many patients, palliative care is about making treatment more manageable.
For example, Dr. Reddy often cares for patients who are pursuing aggressive cancer treatments like chemotherapy and radiation, which can cause distressing side effects.
“These treatments can be really hard for patients, both physically and emotionally. We work to provide as much support as we can to make it manageable,” says Dr. Reddy.
For all of this, palliative care is an extra — not a replacement.
“We don’t take away from any of your other treatments or doctors,” says Dr. Reddy. “We’re an additional support along with everything else that you’re doing.”
It can also make emotional and practical concerns easier.
Whether you’ve just learned your diagnosis or you’ve been living with it for years, palliative care exists to make the experience a little easier for you and your family.
“We check in not just physically, but mentally,” says Dr. Reddy. “You have a whole life before you have this big diagnosis. You have a family, you have a job. So how do you adjust to this big change? We can help.”
This can include:
- Help making informed medical decisions
- Coordinating care among your multiple medical teams
- Helping you talk about your diagnosis and care preferences with loved ones, including children
- Connecting you and your family with support groups tailored to your diagnosis and needs
- Direct emotional support, including for the anxiety, depression and uncertainty that often accompanies a serious illness
- Assisting with other lifestyle adjustments caused or impacted by your illness
“We’re not just taking care of a diagnosis. We’re taking care of you,” says Dr. Reddy. “And you are much bigger than your diagnosis.”
> Read: “Palliative care has been a game changer”: Reno’s story
Bottom line: Palliative care does not mean someone is dying.
It simply means they’re receiving extra support to live as well as possible.
In the past, this type of care was often added in the later stages of a person’s illness — a big reason it’s often confused with hospice. But that’s no longer the case.
Today, healthcare teams are working to add palliative care as early as possible in a patient’s health journey, so they and their family don’t have to wait to experience the benefits.
“When you get the diagnosis, let’s call palliative care early, rather than waiting,” says Dr. Reddy.