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Donna Mae Scheib

Hospice Care and Palliative Care

Posted by Donna Mae Scheib on February 07, 2022

Hospice Care and Palliative Care

You probably have heard about hospice care and palliative care, both services to patients with life-limiting illnesses, but you might not fully understand how they are alike and different. This article addresses the similarities and differences between these two services, their typical use, how to receive the services, where the treatment is usually provided, and the payment methods involved so you have a better understanding of the two care options. This will then help you make a more informed future healthcare decision for you or your loved one, if/when needed.

Similarities and differences in the services

Hospice care

Hospice care uses palliative care methods to provide comfort for your loved one, their family members, their friends, and caregivers. It focuses on the whole patient and their physical, emotional, and spiritual needs. The hospice care administrated involves medical personnel like doctors and nurses as well as counselors, social workers, and clergy members who address the issue of dying and the accompanying emotions that one often experiences (e.g., anger, sadness, regret, etc.) through bereavement counseling and spiritual guidance. Hospice requires a caregiver to be available in the home or other designated place of services as they do not provide full-time caregivers.  Hospice routinely helps with daily activities (e.g., bathing, dressing, and administering medications) by a nurse and nursing assistant who are assigned to the patient. Equipment is provided if needed such as a hospital bed, adjustable table for eating, a wheelchair, floor and bed pads to prevent serious falls, incontinence products, etc. The main goal of hospice is to ease the pain and discomfort of the patient rather than seek a cure to the terminal disease. Hospice is designed to help the family members and others involved with the patient to prepare for the end of the patient’s life, and in doing so, it aims to help them better understand, cope, and live more fully throughout the remaining days and after their loved one passes. The use of hospice care doesn’t indicate that the patient has given up on life but it allows for the highest quality of holistic care for their remaining days and dignified death.

Palliative care

In contrast, palliative care focuses on relieving the symptoms associated with the patient’s present medical condition such as cancer, kidney disease, AIDS, or with side effects of the treatments for any medical condition or disease. Palliative care is a component of hospice care and aims to ease pain and help with the other medical/health problems associated with the chronic or life-threatening illness. This treatment doesn’t replace other medical treatments but it is in addition to the help the patient is already receiving. Palliative care can be added to your loved one’s care plan at any time during their illness and can be incorporated with life-prolonging and curative treatments/therapies. This type of care doesn’t aim to prolong or quicken death but strives to improve the overall quality of life. Like hospice care, palliative care is a multi-disciplinary team-based care methodology that utilizes the skills of many professionals: counselors, specialists, therapists, social workers, and physicians/nurses.

Both services

Hospice care and palliative care aim to treat the patient and their family members through psychosocial and spiritual counseling and to improve the quality of life for all involved. The services also offer medicines that can ease the patient’s pain.  These various medicines range from over-the-counter drugs such as ibuprofen to stronger relief medications with an opioid such as oxycodone or morphine. A medical professional can determine the best way to treat the patient’s symptoms.

Typical use

Hospice care is generally used by those patients deemed terminal (when treatment is no longer curative during approximately the last 6 months of their life). Whereas palliative care is provided when the patient is going through different phases of their life-limiting condition to help the individual live the longest, happiest life possible.

How to receive services

Hospice services − Your loved one must meet certain requirements to be eligible for hospice services.

  • They need to have a hospice medical director and a primary care physician certify a reduced life expectancy (generally 6 months or less).
  • They need to accept the comfort care measures and elect not to pursue any curative treatments.
  • They need to select a specific organization to administer hospice care. Oftentimes, a nursing home, assisted living facility, or hospital/clinic will pair with certain organizations and/or help you find one that can provide services.

Palliative services − To receive palliative care, your loved one can request this treatment through a referral from a physician while the patient is at any stage of the illness.

Where treatment is provided

Hospice care is frequently provided in the patient’s home (whether that is their house, apartment, assisted living facility, nursing home, etc.). The care can also be offered as an inpatient service in hospitals or a specialized center for hospice care. Hospice works closely with your loved one’s physician so the patient can still receive care from doctors that they have developed an ongoing, close relationship.

Palliative care is most often administered in the patient’s home, but this service can also be provided at a nursing home or extended care facility associated with palliative care or during a short-term hospital stay, or at an outpatient clinic. Palliative care also works in tandem with your loved one’s current physician to provide quality pain and symptom relief.

Payment methods

Medicare, the federal health insurance program for seniors, and Medicaid, the federal-state health program for the poor, cover the charges related to hospice care. In addition, the Veteran’s Administration (if you qualify for benefits) and most private insurances cover hospice services as well, either with minimal co-pays or in full. It is best to contact a hospice organization to help navigate the payment options and to address any questions you may have.  You can find more information online or by asking your physician or insurance carrier. If you are residing at a care facility or nursing home, the medical staff can help you find appropriate/available hospice services.

Palliative care is most often administered by your loved one’s regular medical provider and thus is commonly paid for by private medical insurance. In addition, Medicare Part B and some state Medicaid programs will offer some coverage. It is advised to contact your loved one’s insurance provider and palliative care provider prior to receiving any care services to better understand the various payment options and the services provided.

In summary

Hospice care and palliative care are similar services in that they seek to offer compassionate comfort so the patient has a better quality of life when they are undergoing an illness or medical condition. However, there are distinct differences in how the services are used and how they are accessed. Furthermore, where the treatment is provided and the payment for the services also differ.

By learning more about hospice care and palliative care, you are better equipped at making a decision should the time come for you or your loved one. Knowing that you will be supported in life’s journey is comforting in itself and the direct services will only add to that level of comfort.

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