Hospice and palliative care are similar in many ways, but can be difficult to separate. All hospice care is palliative care, but not all palliative care is hospice care. Hospice works to help terminal patients live comfortably at the end of life, while palliative care undertakes the same whole-person philosophy which can be performed for non-terminal patients, helping them live longer, happier lives.Hospice care focuses on a persons last six months of life. The hospice care team comes in to make the patients remaining life as comfortable as possible by addressing physical symptoms and distress as well as emotional and spiritual issues.Palliative care, while also aiming to manage symptoms and enhance comfort and quality of life for patients, can be delivered concurrently with aggressive therapies and therapies that are aimed at a cure. It can be delivered at any stage of life.

Hospice care exists to afford families the opportunity to spend their final moments surrounded by those closest to them, regardless of circumstances. Focusing on quality and comfort when more conventional treatments become burdensome is equally hard. Hospice and Palliative care have shown to enhance the quality of life and help in maintaining the integrity of patients and their families in need of supportive or end-of-life services by offering them symptom management support, comfort, and compassion.You all are doing Gods work, a patient recently told one of Sangre de Cristo Community Cares chaplains when she stopped by to visit with him and his family. He requested a chaplain after his wifes health started to decline. The family was of strong faith, and the husband admitted he hadnt been to church in a while because he had had a stroke and was unable to attend.Both he and his wife were ailing, lying in hospital beds next to each other. Their son, who also lived with them, had his own medical challenges. It was the holidays, and the family was on services with a different company. They needed 24/7 care, circumstances beyond their control. They transferred to Sangre because we have nurses and CNAs who provide care even during the holidays. Many patients have come to an end-stage of their disease: they have chronic health problems that aren't going to go away and will bring further deterioration to the body and or mind. Hospice care focuses on all aspects of a patients life and well-being. Physical, social, emotional, and spiritual services are provided in developing a care plan tailored to the patients individual needs.Emotional and spiritual support is also offered to the patients loved ones as well, including grief support. 

Sarah was young, in her thirties. She had been in a horrific car accident, left a quadriplegic, unable to speak or do anything for herself.She was being kept alive by a feeding tube inserted in her nose. The liquid meals, while keeping her alive, left her more than uncomfortable.Her place of residence was now at a long-term nursing care facility, operated by a hospital. She, like so many of us, had her own story. She didnt have any family to speak for her. Her only way of communicating was by having a pen placed in her mouth and shuffling-out, hard-to-read scribbles.With an attorney by her side, her day had come. She wrote her wishes, asking that her artificial feedings come to an end, her discomfort come to an end, and she be allowed to start comfort care. Sarah was of sound mind, knowingly asking that the regular feedings she received, the dichotomy of her existence, come to a halt and that she receive care to make her comfortable until she could pass. The hospital denied her wishes, and they were within their rights. If death should become imminent, even if the patient is of sound mind when making such a request, it can be denied by way of protection.Talk to your loved ones and make your wishes known. Everyone, over the age of 18 should have their Advance Directives or Colorado Medical Orders for Scope of Treatment (MOST form) completed. This can include a Medical Durable Power of Attorney (MDPOA): this person, also known as your health agent, is able to make decisions for you, regarding your health, if you are unable to do so: guidelines for CPR, medical interventions for treatment and comfort care, full, selective or comfort focused; and information on artificially administered nutrition, long-term/permanent, short-term/temporary or no artificial nutrition by tube.Sarah maintained that the feeding tube was placed against her will; she never wanted it, and had she known the state of which the accident would have left her, she would have been more prepared, would have made her wishes known ahead of time. The artificial feeding afforded her life. But at what costs? Thats to be determined individually. Medically, it would have added fifteen to 2o years to her life. She noted many stomach inconsistencies. She was uncomfortable.Sarahs case was escalated to the state Supreme Court where her wishes were granted. Her regular, artificial feedings were stopped. She was then given small increments of food, spoon feedings, by mouth and medications to make her comfortable.Its not my desire to place judgment on Sarah or her wishes. Only to provide comfort and support to those in need; be-it to patients with serious illnesses, family members grieving the loss of a loved one and in need of support; or quite possibly, to those who have been in a serious car wreck and seeking quality of life and wanting to be comfortable during their remaining days.Editors Note: This article was written by Gina Paradiso with Sangre de Cristo Hospice & Palliative Care and may be reached at 719-542-0032.