The panel: (left to right): Ms Esme Pudule, Dr Lungi Nyathi and Dr Penelope Mathe.
Few people want to think about what happens in a crematorium. Our minds shut down, and we disengage. The same is often true for terms like “palliative care” and “hospice care.” Yet, this is precisely where understanding matters most. Many misconceptions persist about these two forms of care, and the distinctions between them are often blurred.
The differences between palliative and hospice care—and their impact on patients and families—were some of the issues raised in a live panel discussion at the Hospital Show Conference held at the beginning of March.
This conference, co-located at the Sandton Convention Centre with the GP Expo, the Pharmacy Show and SAPHEX, fosters collaboration across healthcare sectors for improved patient care.
The theme for this year centred on Patient Reported Outcome Measures (PROMS) and Patient Reported Experience Measures (PREMS) and the impact of these on different models of care.
It’s a theme that is particularly significant in palliative and hospice care, as it addresses a major transition in a patient’s life.
Said social worker, Dr Penelope Mathe on the panel, “When the AIDS pandemic emerged four decades ago, and although hospices had been around for some time, the term “hospice” unfortunately began to be associated with death. And that death was from a terrifying disease. In South Africa during apartheid the word “hospice” carried a stigma, creating a challenge for those dedicated to this field of care.
Palliative care, at its core, is about ensuring that individuals diagnosed with a terminal illness can continue to live with dignity, with as little suffering as possible, with the best quality of life in a familiar environment and surrounded by loved ones.
Hospice care refers to a programme that gives special care to people who are near the end of life and have stopped treatment to cure or control their disease. Hospice offers physical, emotional, social, and spiritual support for patients and their families.
In simple terms, palliative care focuses on relieving pain and other symptoms of serious illnesses at any stage of the condition. Hospice care, however, is specifically for individuals with a prognosis of six months or less to live.
A Journey, Not an End
Dr. Penelope Mathe emphasised a guiding principle she shares with patients and families: they are “on a journey together.” She reinforced the idea that facing death does not mean ceasing to live.
“Just because you are dying does not mean you have to stop living.”
“The reality is that we all must face death. Palliative care offers individuals better options for how they experience the end of life, ensuring a good quality of life until the very end.”
Palliative care has evolved in the past few decades. Once limited to institutional settings, it now extends into communities, allowing patients to receive care at home. Palliative care nurses and carers make regular visits, ensuring that both social and physical environments support the patient’s needs.
A key strength of palliative care lies in its multidisciplinary approach. Unlike many medical specialties where hierarchical structures dictate decision-making, palliative care teams operate collaboratively, with every member having an equal voice in a patient’s treatment plan.
The most important voice is that of the patient. In an age where AI instantaneously provides an answer to any medical condition, patients are becoming much savvier about their treatment and what they will and will not tolerate.
It’s the person whose very life is on the line that should have the final say in any treatment plan or circumstance that may affect their dignity.
Challenges on the Ground
Esme Pudule, the operations manager of the palliative care centre at Chris Hani Baragwanath Hospital, highlighted a pressing challenge: limited resources hinder the full potential of access to integrated palliative care services.
Dr. Lungi Nyathi, CEO of Alignd—a company dedicated to delivering affordable, high-quality palliative care in the private sector—explained how their model enables patients to access expert care as soon as they need it. Alignd has moved away from a fee-for-service model in favour of an outcomes-based approach, ensuring fair remuneration for palliative care practitioners while allowing medical schemes to provide full coverage in a cost-effective way.
Her passion for patient-centric solutions was evident. She firmly believes that every South African should have access to palliative care when they need it.