An individual with a terminal illness (an illness from which there is little or no chance of recovery and that will most likely cause death in the near future) needs special care, especially as he or she approaches the end of life. Although there may be no chance of recovery from the illness, doctors can help such patients manage the discomfort and pain caused by the illness. Care that focuses on providing comfort rather than life-prolonging measures is called palliative care.
When individuals with terminal illnesses reach the last months or weeks of their lives, they often choose to have this type of care. Hospice care (see below) provides palliative care along with other services to make the dying process more comfortable. The February 8, 2006, issue of JAMA includes an article about palliative care. This Patient Page is based on one previously published in the February 21, 2001, issue of JAMA.
Hospice care is focused on the dying process and helping individuals who are terminally ill (and their family and friends) pass through this process more comfortably. The care may be provided in the patient's home or at a facility designed for patients who are dying.
The goals of hospice care are accomplished by offering services and care to
Manage pain and any other symptoms that cause discomfort or distress
Create a comfortable environment for the patient
Allow the patient to be close to family and loved ones during the dying process
Give relief to the patient's caregivers
Offer counseling for the patient and those close to the patient
Not all hospice programs will include all of the following, but some of the services that may be available are
Physician services, including pain management and other comfort care
Nursing care and services from other health care professionals such as physical therapists
Social services and support
Help with personal care needs, such as bathing, getting dressed, and brushing teeth
Help with everyday activities, such as running errands and preparing meals
Respite-care services that give relief for the patient's at-home caregivers
Grief counseling for loved ones
If you choose hospice care, in addition to your personal doctor, you will be working with a team of health care professionals and volunteers: doctors, nurses, social workers, physical therapists, and volunteer workers.
National Cancer Institute Cancer Information Servicehttp://www.cancernet.nci.nih.gov
The Hospice Association of Americahttp://www.hospice-america.org
To find this and previous JAMA Patient Pages, go to the Patient Page Link on JAMA's Web site at http://www.jama.com. A Patient Page on palliative care was published in the March 16, 2005, issue; and one on palliative sedation was published in the October 12, 2005, issue.
Sources: National Cancer Institute, American Academy of Family Physicians, National Hospice Foundation, Hospice Association of America, The AMA Family Medical Guide, The AMA Complete Guide to Women's Health, The AMA Encyclopedia of Medicine
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724
TOPIC: HOSPICE CARE
Pace B, Burke AE, Glass RM. Hospice Care. JAMA. 2006;295(6):712. doi:10.1001/jama.295.6.712