By Lindsey Buddelmeyer 
Leadership Education & Training Specialist, Human Resources – Blanchard Valley Health System

It was the last meaningful conversation that I would have with my grandfather. It involved a deeper level discussion about what it means to be a caregiver for a loved one facing Alzheimer’s disease. He looked at me with his pale blue eyes and said, “Now take our story and do something great. If anyone can take our pain and do something to help others, it is you.” As a granddaughter, educator and an occupational therapist, I have taken these words to heart. I think of my grandparents daily in the work that I do and the privilege I have had in serving others as a healthcare provider and educator. A critical and important part of health care I learned about during our journey with Alzheimer’s disease involved two different models of care: palliative and hospice care. While many believe palliative care and hospice to be the same, they are actually quite different.

According to the Centers for Disease Control, six in 10 Americans are living with a chronic illness. Palliative care is a patient and caregiver-centric model of health care that believes in helping patients living with chronic illness best manage their symptoms to improve and/or preserve quality of life. This is done by providing interdisciplinary care and wrap-around services that are tailored and supportive to meet the unique needs of each individual. Palliative care offers those facing chronic illness the ability to feel more supported, knowing there is an additional team of trained professionals to assist, provide, and manage their care. Curative treatments and measures may continue to be pursued and attending providers and physicians are not replaced, rather, work in conjunction with the palliative care team. Palliative care services may be provided in the home, a hospital, an outpatient setting or clinic, and/or a skilled nursing facility and may be set up weekly, monthly, or on an as-needed basis as established by the provider and patient. 

Hospice, on the other hand, is a type of palliative care and offers its own distinctive features as people face end-of-life decisions and care. This approach involves a team of interdisciplinary care professionals and is a 24-hour/day, seven-day/week operation. A patient qualifies for hospice when he/she has been given less than a six-month prognosis by a physician. This service is most often used with days remaining, whereas, it is most beneficial for patients. When used at or as close to that six-month projection, patients may benefit from all of the support and services they are afforded under hospice. Hospice care may be provided to alleviate pain and symptoms, offers a holistic approach to the mind, body, and spirit, and when the patient no longer wishes to seek out aggressive, curative treatment. Bereavement services are also included for patients and families both during and for up to a year after the patient has passed. Hospice services may also be provided in the home, hospital, assisted and skilled-nursing facilities, and in designated care centers.

By the end of our journey with Alzheimer’s disease, we learned about these different models of care. We were not equipped from the beginning to understand the breadth and depth of what palliative and hospice care could offer. As I reflect and look back, we faced unnecessary hospitalizations, ones that could have been avoided. We were operating in a trial-by-fire type of environment. I hope that if you or a loved one is facing a chronic or terminal illness, the above information can help you make a decision that best fits your needs. It is your story to tell, so choose a model of care that will help support you so that you can live your best life.