Care aimed at relieving suffering and improving the quality of life is called palliative care. The focus of care is on the patient and family rather than the disease. Palliative care treats pain and other symptoms caused by the disease. Some health professionals call this supportive care.

Common physical symptoms that are treated and controlled or relieved by palliative care can include:

• pain
• breathing problems
• appetite loss
• weight loss
• fatigue
• depression and anxiety
• confusion
• nausea and vomiting
• constipation
• bowel blockage

The goal of palliative care is to prevent and relive suffering and to support the best possible quality of life for patients and their families, regardless of the state of the disease.

Care can be given at home. Some cancer centers actually have special palliative care teams that can help. The team usually has professionals with extra training in cancer and hospice care. Members may include a doctor, chaplain, social worker, nurses, home health aides, physical therapists, a dietitian, pharmacist, and breathing (respiratory) therapist. The palliative care team works with the patient's doctor to:

• develop treatment plans
• manage pain and other symptoms
• give emotional support
• help deal with end-of-life issues

When the Focus Is on Care: Palliative Care and Cancer is a book by the American Cancer Society that discusses many of the questions you may have and provides a list of very helpful resources. Call us or visit our Web site for more information.

Home care

Home health care is professional health care given in your home. Home care may be right for you if you still need care but no longer need to be in a hospital. A wide range of health and social services can be given at home to people with cancer.

Many home health care agencies offer care and support for patients who choose to stay at home. Home care usually includes regular visits by health care professionals. But the family is still responsible for most of the care. It is important to talk with your cancer care team so that you understand what types of care will be needed and how this will affect your family. It also important to check with your health insurance company to know if they will pay for home care.

Sometimes, the family can’t go on caring for the patient at home. There may not be enough family members to provide all the care needed or the care may be too complex to be given at home. If this happens, family members may feel guilty, especially if they had promised to care for the patient at home. Recognizing the efforts of family members can help them cope with these feelings. For more information, please see our document, Home Care.

Hospice care

A hospice is a program designed to give palliative or supportive care near the end of life. The right time for hospice care is when treatment aimed at a cure is no longer helping the patient and the patient is thought to have about 6 months to live. But hospice patients can live longer. Together, the patient, family, and doctor decide when hospice care should begin. Many professionals in the field feel that patients are referred to hospice too late. There is much that a hospice program can do for you and your loved ones, and most provide care to the patient in their home.

Hospice sees death as the natural, final stage of life. It seeks to manage a patient’s physical and emotional symptoms. The goal of hospice is that the person’s last days be spent with dignity and quality, surrounded by loved ones. Hospice care affirms life and neither hurries nor postpones death. Its focus is on quality of life, rather than length.

Hospice programs offer family-centered care. They involve the patient and family in making decisions. Hospice care is usually given in the home. But there are a few hospitals that offer hospice care and some private hospice centers. Hospice care can also be made available in some nursing homes.

In a hospice program, a team will usually care for you. The team will have a medical director who is a doctor, a nurse, a nurse’s aide, a social worker, and a chaplain. In most cases, your own doctor will also play a role.

There are over 3,000 hospice programs in the United States. Most of these are designed to provide care in your home. You can find out about hospice in your area by calling Hospice Link at 1-800-331-1620. Many Web sites can also give you information about hospices. (See the section, "Additional resources")

It can be hard to decide to begin hospice care. In general, it means you are giving up any treatment aimed at killing the cancer. Most hospice programs do not allow patients to get treatments such as chemotherapy, radiation, transfusions, or IV nutrition. An honest talk with your doctor can help you decide if that is the right thing to do. Ask whether any treatment your doctor suggests offers hope for a cure. If a cure is not possible, will the treatment prolong your life or relieve any of your symptoms?

You should think about hospice if your doctor can’t assure you that treatment will meet any of these goals. A hospice program may give you the best chance of controlling your symptoms and keeping the quality of your life. Most experts in palliative care feel that patients and their families enter hospice programs too late to get their full benefit.

Last Medical Review: 01/28/2009
Last Revised: 01/28/2009