The muddied waters of medical terminology

I thought I would take today’s blog to address a question I’m often asked as a palliative care doctor: what are the differences between palliative care and hospice care?

It can be very confusing for people especially as the terms can have different meanings depending on what part of the world you live in. In Canada, the terms are often used interchangeably to describe end-of-life care. Generally speaking, the term ‘palliative’ is used to refer to the type of care being received, while a hospice often refers to the location of that care (often outside of the hospital setting). Because Canada has relatively few residential-style hospices there is a specific criteria for admittance. Generally speaking, people are admitted to hospices when they need specialized care that they can’t receive at home, but whose conditions are not acute or complex enough to merit hospitalization. But the relatively small number of facilities here means that much end-of-life care in Canada is administered in a hospital’s palliative care unit or in the home.

And this is why things can get confusing.

One of the most common misconceptions about palliative care is that anyone who receives it is necessarily dying. But the fact is, that anyone experiencing a life-limiting condition can benefit from palliative treatments, the idea being that medical assistance can be provided to ease the suffering of anyone at any stage of an illness. Many people in palliative care are undergoing life-prolonging treatments with the goal of resuming ‘life as normal’ upon leaving the facility.

There are also tertiary palliative care units (such as those found in Surrey or Edmonton), designed as emergency facilities to help stabilize rapidly declining patients so that they might ultimately be moved home or to another facility.

As I’ve mentioned, it can be very confusing for patients and families to decode all the differences between programs. Ultimately it’s most important for you to talk with your physician or specialist about all the options available. And as always, ask as many questions as you need to—always make sure you get the answers you need to make the best decision for you or your loved one.

For more information about palliative care in Canada, there are excellent resources available at: www.virtualhospice.ca

 

 

 

Still learning after all these years…

So we’ve just hit the first official days of autumn, and by now students of all ages are firmly ensconced in their studies, whether that be at elementary or high school, university, or even preschool. The rush for school supplies those first weeks of school, seeing all the college students taking over cafes with their binders and textbooks, all of it reminds me of the real joy that is learning.

I think there’s a tendency to think that when we’re done our ‘official’ education programs—when we flip over our tassels and are handed our diplomas and what-have-yous—that the ‘learning’ part of our life is over. My profession is the perfect example of how far from reality that is.

Doctors, if they want to continue to be effective, are necessarily engaged in a process of life-long learning. Just think about it: new scientific breakthroughs, new approaches to our understanding of mind and body, new treatments are always appearing. And wouldn’t your doctor to be on the cutting edge of all that news and information? Of course you would! And the only way that happens is if they retain an active commitment to learning.

But I’m also referring to more informal learning as well. In palliative care we learn that one of the most important parts of our jobs is listening. There is absolutely no way you can be an effective palliative practitioner without listening to your patient; most of the work we do is dependent on being able to assess what they need from us.

And by listening I learn not only about how best to treat my patients, but I learn more about myself. Sure, by listening to patients you’ll learn about their symptoms and how best to manage their pain, but you’ll also learn more about the human experience by listening to their stories and experiences; I can’t imagine an education more valuable than that.