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Advances in medicine in the last 100 years have greatly benefited us in so many ways. Many diseases have been eliminated, and we now have cures for illnesses that used to result in death. Because of our current health care system’s focus on curing disease and extending life, many lives have been saved and much suffering has been prevented. However, with our focus on curing disease and extending life, it has become difficult in our Western health care system to talk about death and dying.

Palliative care and hospice care are two systems for delivering care that focus on improving the quality of life for patients. According to the World Health Organization, palliative care is an approach to care focused on improving the quality of life of patients and their families facing life-threatening illness.

Of primary importance is the control of physical symptoms, including pain and of social and spiritual problems. The goal of palliative care is achievement of the best quality of life for patients and their families.

Hospice care is intense palliative care provided to patients and families as the patient moves closer to the end of life. To qualify for most hospice programs, the patient must have a terminal illness and no more than six months to live. Palliative care and hospice care programs affirm life and regard dying as a normal process. The goals of both are neither to hurry nor to postpone death.

Palliative care programs are attempting to bridge the gap between healing care and death in western medicine. People are living longer and typically die as a result of slowly progressing chronic disease. In order to ensure that death happens with dignity and quality of life is sustained throughout the treatment and progression of disease, it is important to be aware of all health care options, including palliative care and hospice.

Death and dying are still difficult topics to discuss for many people - including health care providers. Because of this, never assume that loved ones or health care providers know or understand your wishes. Quality of life is an individual preference and what is important to one person when faced with a chronic or life-threatening illness may be different for another person. Discuss your wishes about end-of-life care with your loved ones and your health care providers.

Excellent end-of-life care is the goal throughout our nation’s health care system. In order for this to happen, there must be good communication between patients and health care providers. We must also realize the limitations of modern medicine and the realities of life-limiting diseases and communicate our end-of-life wishes to those who love and care for us.

Anne Hoppie is a registered nurse at St. Patrick Hospital in Missoula.

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