For health care providers caring for older adults, the transition from chronic disease management to comfort care is rarely marked by a single, definitive event. Instead, it is often signaled by an increase in frailty: a multi-dimensional condition characterized by decreased bodily reserves and increased vulnerability.
Recognizing this shift is critical as traditional medical care no longer may be the best fit for the patient’s needs. By initiating timely conversations about palliative or hospice care, clinicians can help their patients find the best form of support for their evolving needs. Learn more about frailty and determining when palliative or hospice care would be beneficial.
The medical community’s understanding of frailty has evolved, and exact definitions vary. Generally, frailty can be understood as a reduction in the body’s reserves, leading to a vulnerable state and weakened ability to recover from illnesses and injuries.
A relationship can exist between age and frailty. Frailty is not limited to older adults, and not all older adults experience frailty, but the condition becomes increasingly common with age, affecting about 1 in 10 people over 65 and 1 in 4 people 85 and older.
Frailty involves symptoms like:
Frailty may be reversible for some older adults, but for those with life-limiting illnesses, it can be a sign that a patient and their care team should shift focus from curative treatments to palliative or hospice care.
As a patient becomes more frail, clinical teams may shift their focus from curing or managing illness to optimizing the patient’s comfort at home. Both palliative care and hospice care can help accomplish this goal. These specialized models of care assist chronically ill patients through:
Although palliative and hospice care share a similar philosophy and interdisciplinary model, they are not interchangeable. For providers, the primary distinction lies in the patient’s prognosis and concurrent treatments. Palliative care can support patients who are not ready for hospice care, either because they wish to continue curative treatments or because they don’t yet qualify for hospice services. Hospice is intended specifically for patients with a life expectancy of six months or less.
For a patient experiencing the gradual decline of frailty, palliative care acts as an extra layer of support or as a bridge to hospice care. For patients who receive palliative care, the transition to hospice can feel far more seamless and can ensure they feel fully supported at each stage of their condition.
Unfortunately, despite experiencing frailty, many patients never access palliative care and access hospice services only in the last stages of an illness. In 2022, half of hospice patients were enrolled in hospice care for 17 days or fewer, and one in 10 patients was enrolled for just one or two days.
Waiting for a medical crisis to refer a patient to palliative or hospice care often limits the patient’s ability to benefit from the full scope of available support. Early intervention can be a powerful means of helping patients and their families benefit from:
When is it time for palliative care? While palliative care is available whenever a patient might benefit, it is especially valuable for those experiencing frailty who do not yet qualify for hospice.
A patient may benefit from palliative care if:
Hospice provides comprehensive end-of-life care for patients who likely will live six months or fewer. . In some cases, providers can have a difficult time assessing whether a patient is ready for hospice. (When in doubt, palliative care is an excellent option to consider.)
A patient may be ready for hospice care if:
WesleyLife provides both in-home palliative and hospice care to support aging and frail patients. Our interdisciplinary teams support patients’ physical, mental, emotional, and spiritual needs. We work with health care providers like you to provide expert symptom management, education and emotional support for caregivers, coordination with the care team to prevent avoidable hospitalizations, and a holistic focus on comfort, dignity, and quality of life.
When you determine it’s time for palliative care or hospice care, no matter the day or time, our team is ready to support an expedient referral process to provide uninterrupted care for your patient.
Learn more or refer a patient here.