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What's the Difference Between Palliative Care and Hospice Care?

緩和醫療與安寧療護的不同[1]

If you or loved ones are facing a serious illness, you’ve probably been hearing a lot about treating pain. You may have heard the terms “palliative care” or “hospice.”

假如你或你的親人患有重病，你可能已經聽過許多關於治療疼痛的資訊，也可能聽過「緩和醫療」或「安寧療護」這兩個說法。

Both are meant to bring comfort and relief, but they differ in some important ways. To get the right kind of care in your situation, you need to have a good idea of what each service offers.

照理而言，這兩者都是為病患帶來舒適與慰藉，但在某些重要的方面上，它們卻有所不同。為了能夠針對病情，取得正確的照護，得先好好了解這兩者所提供的服務有哪些。

What Is Palliative Care?

什麼是緩和醫療？

This program aims to ease pain and help with other problems if your illness is serious but not considered to be life-threatening for now.

緩和醫療的目的在於緩解疼痛並幫助解決其他問題，這適合雖然嚴重但目前還不會危及生命的疾病。

It helps people live with the symptoms of long-running things such as cancer, kidney disease or AIDS, or with the side effects of the treatments.

它可以幫助病患適應具有長期症狀的疾病，如癌症、腎臟疾病或愛滋病，或者幫助病患適應治療時的副作用。

Palliative medicine doesn’t replace other treatments. It’s an addition that helps you and your family deal with things such as nausea, nerve pain, or shortness of breath.

緩和醫學並不能取代其他的治療方法，但是可以輔助病患處理噁心、神經疼痛或呼吸短促等問題。

If an illness makes it harder to work, play, get around, or causes depression, palliative care can address that, too. People have said they feel more in control of their lives as a result.

若患有的疾病會造成工作上、玩樂，甚至走動上的困難或導致憂鬱症，那麼也能利用緩和醫療來解決這些問題。患者們都說在接受治療後，覺得更能掌控自己的生活。

Even in cases where an illness is expected to be fatal, this type of care can help you live as active a life as possible.

即使在疾病是致命的情況之下，這種類型的照護也能幫病患盡可能地過上積極的生活。

What Is Hospice Care?

什麼是安寧療護？

This is for people who have learned from doctors that they are not expected to recover from their condition. It’s about easing pain and helping families prepare for the end of life. Palliative care is part of that, but it’s just one part.

安寧療護適用於醫生確診可能無法康復的病患，它主要是用來幫助病患緩解痛苦以及幫助家屬為病患生命中的最後一段路程做好準備。緩和醫療也包含在此，但只是這其中的一環。

People in hospice care generally are expected to have less than 6 months to live. They’re often at home, where family members and professional caregivers look after them. But you could also choose a specialized center for hospice care. It’s also offered at many nursing homes and hospitals.

受安寧療護的患者通常只剩下大概不到6個月的生命。這類的病患通常由家屬和專業的護理人員在家照顧，但也可以選擇專門的安寧療護中心。許多療養院和醫院也有提供安寧療護的服務。

This kind of care can involve not only doctors and nurses, but family members, clergy, counselors, or social workers who can address the grief of dying and emotions (such as anger, sadness, or regret) that often come with it.

此種照護的參與人員不僅包括醫生和護士，還包括家庭成員、神職人員、輔導員或能夠處理伴隨著死亡而來的悲傷和情緒（如憤怒、難過或遺憾）的社會工作者。

Easing Your Pain

緩解疼痛

Both palliative care and hospice care offer medicines that can ease your pain.

緩和醫療和安寧療護皆有提供緩解疼痛的藥物。 

Those can range from over-the-counter drugs such as ibuprofen to stronger relief with opioid medications such as oxycodone or morphine.

這些藥物的範圍可以從ibuprofen等非處方藥物到強效緩解的鴉片類藥物，例如oxycodone或嗎啡。

The misuse of opioiods has become a big concern, and you or a loved one might not want to take them because you’re afraid of becoming addicted. This can be a particular worry if you’ve already had problems with drugs or alcohol. But you might be rejecting pain drugs needlessly.

鴉片類藥物的濫用已成為一大問題，病患可能會因為害怕上癮，而不想使用這些藥物，尤其是那些已經有毒品或酗酒問題的病患更會擔心這個問題。不過，其實大可不必拒絕服用止痛藥。

Researchers say people who are prescribed opioids during these kinds of cases, and use them as directed, rarely become addicted to them. It’s OK to take them instead of suffering.

研究人員表示，在這類病例中，依照指示服用醫生所開出的鴉片類藥物的患者，很少會對藥物上癮。所以服用這些藥物是可以的，不用選擇承受痛苦。

These drugs do have side effects such as drowsiness, nausea, and constipation. Those problems usually fade as your body gets used to the medication. Your doctor should be able to help you decide whether to start taking them and how much you need.

這些藥物確實是有副作用，例如嗜睡、噁心和便秘。但是當身體習慣這些藥物時，這些問題通常都會逐漸消失，而醫生會幫助病患判定是否要開始服用藥物以及需要服用的劑量。

Will Insurance Help Pay for This?

保險有給付嗎？(美國)

Medicare, the federal health insurance program for seniors, pays all charges related to hospice care. So does Medicaid, the federal-state health program for the poor. Most private insurers cover it as well.

聯邦醫療保險(Medicare)是針對老年人的聯邦健康保險計劃，它能給付所有與安寧療護有關的費用。針對窮人的聯邦政府健康計劃，即低收入戶政府醫療補助(Medicaid)也是如此。此外，大多數的私人保險公司也有承保安寧療護的部分。

Palliative care is not as well-covered. Medicare and private insurers cover some medicines, but not others. You may want to check your policy or call your insurance company to find out.

緩和醫療卻沒有完全承保在內。聯邦醫療保險和私人保險公司僅包含部分藥品。完整的細節則需自行查看保單或致電保險公司查詢。