Home palliative care refers to long-term management of serious illness in the patient’s home. While palliative care often means end of life care and pain management, the term is not limited to hospice care and may be appropriate for patients expected to recover. Home palliative care teams usually include doctors, one or more full-time caregivers, and nurses or other service providers.
As the aging population in developed countries increases, a growing number of people want the option of recovering at home from devastating treatments like chemotherapy. Many people are also choosing to die in familiar settings with family members nearby rather than in an institution amongst strangers. Home palliative care gives people this option.
Home palliative care teams may be trained to care for the symptoms of specific illnesses such as AIDS or cancer while others may deal only with geriatric or pediatric patients. Since doctors often can only work with the physical aspects of a patient’s suffering, palliative care team members deal with the psychological and social aspects of pain and dying. Most people involved with this type of care are also trained to help the patients’ families by teaching them to support the patient and working with them on bereavement issues.
The goal of home palliative care is to improve a patient’s quality of life as much as possible. This means not only making the patient comfortable by managing pain and respiratory problems, but to provide treatment for all aspects of long-term illness including depression, feelings of helplessness, and spiritual issues. Housekeepers, clergy, and visiting nurses offer support not only to the patient but to the caregivers as well. Caregivers may be paid or volunteer staff, friends of the patient, or member of the patient’s family.
In most home palliative care and hospice care programs, a primary caregiver is trained in administering medication as well as other aspects of care such as using medical equipment, and feeding and bathing the patient. Most programs also offer respite options for caregivers in need of a break, either by providing another temporary home caregiver or moving the patient to a treatment facility.
Home palliative care for terminal patients is not intended hasten the patient’s death, and generally no measures are taken to prolong life by treating the illness. Sudden instances of acute illness are dealt with according to the patient’s wishes, usually described in a living will. Some patients may opt for heroic measures such as resuscitation while others may request to have their deaths occur as painlessly as possible without heroic measures.
