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End-of-life care vs palliative care – what are the differences?

At the Future Care Group, the well-being of our residents is at the heart of everything we do. In this article, we explore the insightful concepts of end-of-life care and palliative care. Our carers understand the significance of providing unwavering support during the final stages of life, and we are committed to illuminating the differences between these two essential aspects of compassionate care. We delve into the delicate intricacies of ensuring comfort, dignity, and holistic support for our residents and their families during these deeply meaningful moments.

What is meant by palliative and end-of-life care?

Palliative care is a holistic approach that aims to improve the quality of life for residents facing serious, chronic, or life-threatening illnesses. It is not limited to end-of-life situations and can be provided at any stage of an illness, often alongside curative treatments. Palliative care is available when you first learn you have a life-limiting illness. 

In comparison, end-of-life care is a specialised form of palliative care that focuses on individuals who are in the final stages of a terminal illness or those who are approaching the end of their lives. At the Future Care Group, we refer to a resident being ‘palliative’ when they are in the last year of life, and we refer to those within the last few days/weeks of life, as ‘end-of-life’.

What is the difference between palliative and end-of-life care?

Palliative care and end-of-life care share common goals in enhancing the quality of life for individuals facing serious illnesses, but there are distinct differences between the two:

Timing and focus

As we mentioned earlier, palliative care can be provided at any stage of a serious illness, not just at the end of life and can run concurrently with curative treatment, addressing symptoms, and improving the overall well-being of the resident. As many of our residents have an average residency of 9 months, you could argue that most are considered ‘palliative’ when they arrive in our homes. 

End-of-life care is a dedicated form of care specifically tailored for individuals that are heading towards losing their life. Our focus is on ensuring comfort, managing symptoms, providing support (for both residents and their loved ones), and ensuring that all their wishes are carried out as requested. 

Treatment goals

During palliative care, the emphasis is on improving a resident’s quality of life by managing symptoms, addressing emotional and spiritual needs, and providing support throughout their palliative phase.  

Our carers spend a lot of time with new residents to understand their wishes and aspirations whilst receiving palliative care. If a resident has a particular desire to accomplish something in their final months, we do our best to help them achieve it. If it is a wish that is out of reach, we always strive to think outside the box for the next best solution. For example, is a resident has always wanted to go to a pop concert, but are too sick to travel, we would do our best to recreate a concert for them at our care home! 

The goal of end-of-life care is to ensure comfort and dignity during and after the final stages of life. It often involves a shift from curative treatments to a focus on symptom management and emotional support. We like to open discussion with residents around end-of-life care planning as soon as they arrive in our care, no matter their prognosis. This way, residents are able to articulate their needs and wants themselves before they become too ill to communicate with us effectively.  We try to delve into as much detail as possible to ensure their final days are exactly how they want them to be. We cover topics such as:

  • Who would they like with them when the time comes. Is there anyone that they do not wish to see them in that condition?
  • What they do and do not want to happen.
  • Do they have an advanced plan in place? If so, who is their funeral director?
  • Would they like to be buried or cremated? If it’s a cremation, we will need signatures from two doctors on the forms, whereas if its’s a burial, only one signature is required.
  • What is their preferred place for end-of-life care – do they want to stay with us and be cared for in the home until they pass? Or do they wish to be admitted to hospital or transferred to a hospice. 

We even cover smaller details such as what music they would like to be played whilst receiving end-of-life care. Understanding a resident’s needs and wants regarding both their palliative and end-of-life stages of care ensures that we can deliver and support the resident and their relatives without hesitation when that time comes. 

Duration of care

Palliative care can be provided for an extended period, potentially for years, depending on the course of the illness. For example, residents may receive palliative care alongside their chemotherapy treatment for cancer. End-of-life care, on the other hand, is provided in the last weeks of life when it becomes clear that an individual is approaching their close. 

Scope of services

At the Future Care Group, we can facilitate a broad range of services during their palliative care, including:

  • Regular assessment and management of pain and other symptoms associated with the resident’s medical condition.
  • Adjustments to medications to optimise symptom control and minimise side effects.
  • Skilled nursing support to monitor the resident’s health status, administer medications, and provide specialised care as needed.
  • Assistance with activities of daily living (ADLs) to maintain comfort and dignity.
  • Counselling services for the resident and their family to address emotional and psychological challenges.
  • Support for coping with the emotional aspects of a serious illness, including anxiety and depression.
  • Facilitation of open and honest communication about the resident’s prognosis, treatment options, and goals of care. 
  • Assistance with advance care planning to ensure the resident’s preferences are documented and respected.
  • Assistance with practical matters, such as coordinating care, addressing financial concerns, and connecting the resident and family with community resources.
  • Complimentary therapies, such as Namaste sessions which use massage, music, and other stimuli to enhance overall well-being.
  • Lifestyle Leads create opportunities for residents to engage in meaningful activities and create positive experiences.
  • Support for family members and caregivers, including education about the resident’s condition, and emotional support.
  • Collaboration with other healthcare professionals, such as hospice providers, to ensure a seamless and comprehensive approach to care.

While end-of-life care includes many palliative care components, it essentially focuses on preparing for the end-of-life, addressing unique needs that arise during this period. These include preferences for medical interventions, frequent administration of pain medications, coordination of care, bereavement support for family members after the resident’s passing, cultural sensitivity – respecting cultural rituals or spiritual practices. 

Examples that illustrate palliative care

1. Cancer resident undergoing treatment

Scenario: A resident diagnosed with advanced cancer is receiving aggressive treatments such as chemotherapy.

Palliative care intervention: Palliative care is integrated alongside the curative treatments. The palliative care team focuses on managing the side effects of chemotherapy, alleviating pain, and providing emotional support to improve the resident’s overall quality of life.


2. Heart failure resident

Scenario: An individual with chronic heart failure experiences symptoms like shortness of breath, fatigue, and anxiety.

Palliative care intervention: Palliative care is initiated to address the ongoing symptoms. Medications are adjusted to improve symptom management, and the palliative care team works with the resident to enhance their emotional well-being and ensure their preferences are respected.


3. Alzheimer's disease resident

Scenario: A person in the advanced stages of Alzheimer’s disease experiences cognitive decline, communication difficulties, and behavioural changes.

Palliative care intervention: Palliative care in this context focuses on improving the resident’s comfort, providing support for family caregivers, and addressing the emotional and psychological challenges associated with the progressive nature of the disease.


Examples that illustrate end-of-life care

1. Terminal cancer resident 

Scenario: A resident with terminal cancer, for whom further curative treatment is no longer beneficial, has chosen to be transferred from our home into hospice care.

End-of-life care intervention: The emphasis shifts towards comfort and quality of life. The hospice team provides pain management, emotional support, and helps the resident and family navigate end-of-life decisions before arranging their transfer into a hospice facility. The focus is on creating a peaceful and supportive transition during the last weeks of their life.


2. Elderly resident with advanced organ failure

Scenario: An elderly resident is in the advanced stages of organ failure and has chosen to forgo aggressive interventions.

End-of-life care intervention: The care team collaborates with the resident and family to ensure that the resident’s wishes are respected. Palliative measures are implemented to manage symptoms, and emotional support is provided to both the resident and their loved ones as they prepare for the inevitable.


3. Late-stage neurodegenerative disease resident

Scenario: An individual with a progressive neurodegenerative disease has reached a point where curative treatments are no longer effective.

End-of-life care intervention: The care team focuses on enhancing the resident’s comfort, facilitating communication about end-of-life preferences (if not done already), and offering support to the family as they navigate the challenges of this stage.

As you can see, these examples highlight the varied and personalised nature of both types of care, demonstrating the importance of tailoring care to the unique needs and preferences of the individuals in our care. This ensures the one opportunity we get to deliver gold standard end-of-life care is fulfilled. 


What are the challenges for delivering end-of-life and palliative care?

While it may all sound straightforward, delivering end-of-life and palliative care in our care homes isn’t a walk in the park. There’s a bunch of challenges that pop up, thanks to all the complicated medical provisions, emotions, and the logistics of it all. Let’s break down some of these hurdles: 

  • Staff training and education – the end-of-life stage is a sensitive topic to address and an even harder time to witness and be involved in. Staff require specialised training in palliative and end-of-life care, including communication skills, and emotional support.
  • Communication and decision-making – navigating end-of-life discussions and assisting residents and families in making difficult decisions can be very challenging. We always aim to implement clear communication protocols and encourage early discussions about end-of-life preferences where possible.
  • Resource allocation – allocating resources, including staffing and specialised services, to meet the unique needs of residents in the end-of-life stage may be a challenge. We collaborate with external hospice services where possible to aid this.
  • Staff burnout – Providing consistent emotional support for residents, families, and staff members can be emotionally taxing.
  • Addressing care gaps – navigating complex regulatory frameworks, ensuring compliance with policies, and coordinating care transitions can be complex and time consuming. This may lead to gaps in care.

If you or a loved one are in need of end-of-life care, why not book a visit to one of our homes? Alternatively, call 02045 710 368 or email and a member of our team would be happy to help. 

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