269 - Principles of Palliative Care

Question 1

What are the differences between palliative care and hospice?

Answer 1

• Palliative
  
  • Can be used in conjunction of other therapies
  • Applicable at any time in the course of the illness
• Hospice
  
  • Goal is comfort, not cure
  • Applicable at the end of illness (usually when <6 months predicted left)
  • Capitated/managed system

Question 2

What are some of the conceptual challenges of palliative care?

Answer 2

• Caring vs. curing
  
  • Hard to draw the line; many treatments do both
• Prognosticating is hard, and we are poor prognosticators
  
  • we are inacurate (usually too optimistic) and too hesitant to give a clear answer
• “we like to win”, but that is not reflective of real life outcomes

Question 3

What is the goal of palliative care?

Answer 3

Make quality of life as good as possible until death

Not intended to hasten or postpone death

Question 4

According to the studies referenced by Dr. Hauser, what are some of the evidence-proven benefits of palliative care? (5)

Answer 4

• Fewer hospital and ICU days
• Increased pt and provider satisfaction
• Lower costs of care
• Better for famlilies; less anxiety, PTSD, depression, need for psychotropic medication
• Survival advantage