What is Hospice? Palliative Care?
In human end of life care, there is a sharp delineation between hospice, palliative care, and medical care. In veterinary medicine, things are a little messier. This is partly due to medicare, which requires a terminal diagnosis with death expected within the next 6 months before a patient can receive hospice. In veterinary medicine, we do not have to meet any specific requirements to ask for hospice or palliative care, and the practice of palliative medicine is still very new and developing. In fact, much of what veterinarians and veterinary technicians or nurses do for an animal throughout its life is considered palliative care, which is defined as simply attending to the physical and emotional comfort of the patient, rather than effecting a cure.
Palliative care is often provided along with more traditional medical management of a disease, while, at least in the United States, hospice is a special type of palliative care not considered until the patient and family have chosen to stop pursuing disease modifying treatments. Palliative care should begin as soon as we recognize a pet has discomfort, while we are pursuing a diagnosis, while we are pursuing treatment and a cure.
Hospice is a special type of palliative care that focuses not only the sick or dying individual's comfort, but on their life as a whole, and what brings it meaning. Hospice considers emotional, spiritual, mental, and physical of the patient, and tailors the patient's care to what they value and want. Further, hospice considers the patient to be the sick or terminally ill individual AND THEIR FAMILY to be the patient. It is truly a holistic, interdisciplinary model of care, with outcomes focused not on rates of cure or length of time before death, but on making the most of the time the patient and family have together. Hospice brides the gap between medical interventions and "there's nothing more we can do."
More information on animal hospice and palliative care can be found at: