By Amy Rowan
Options Counselor for the Area Agency on Aging
Member of the ADRC
Knowing the difference between palliative and hospice care is critical to getting the service that you or your loved ones need.
Palliative care is an unclear and often confusing term to describe a type of treatment aimed at relieving symptoms of a serious illness or condition and works to improve a patient’s quality of life. It may or may not be used for end of life care, and it is NOT hospice care. Palliative Care can begin at any time during a serious illness and ideally should start at the time of diagnosis.
Palliative Care is most often utilized by cancer patients, but other serious illnesses may also benefit from palliative care. Patients with heart failure, lung disease, liver failure or any serious illness that negatively impacts a patient’s quality of life can benefit from palliative care.
Palliative care is often carried out by a team of professionals who can address multiple concerns. The team includes: palliative care physicians, palliative care nurse practitioners, nurses, social workers, chaplains and therapists (occupational, speech, physical, etc.) The most important member of the palliative care team is the patient. Palliative care also addresses emotional suffering and spiritual care needs. Palliative care us usually not covered by insurance, patients usually private pay for services and services are delivered most often in a hospital setting, but may be available in home as well.
Hospice care is a form of palliative care designed to relieve symptoms and improve quality of life, but hospice is restricted to patients who are terminally ill with a life expectancy of less than six months.
Hospice is not intended to hurry death or “assist” someone to die, but rather to help patients live the remainder of their lives as fully as possible. Most people, if asked, will say they dream of a peaceful, comfortable death surrounded by their loved ones.
Hospice care service are provided in the patient’s home, but Hospice care does not provide around the clock nursing care, so many patients are either cared for by family members, hired caregivers, or nursing home staff, or admitted to inpatient hospice facility.
Benefits and services provided by hospice have been defined by the Medicare Hospice Benefit and are the same whether hospice care is covered by Medicare, Medicaid, private insurance, or charity. The benefits and services pertaining to the diagnosis often include: nursing services, physician participation, medical social services, counseling services, home health aide, personal care assistance, medications management, medical equipment/supplies, diagnostic studies, and therapists.
Knowing the differences will help you make choices in your care:
- Hospice care is appropriate during the last 6 months of life.
- Palliative care should start at the time of diagnosis.
- Hospice care usually cannot be given at the same as curative or aggressive treatments such as chemotherapy, radiation, blood transfusions, etc.
- Palliative care occurs simultaneously with aggressive or curative treatments, often managing symptoms that these therapies cause.
- Hospice care is paid for in full by the Medicare benefit and by Medicaid (in most states). Most insurance also cover hospice services in full or with minimal co-pays.
- Palliative care is often underfunded and difficult to access in many areas.
- Hospice care most often provides care in a patient’s home setting. That could be at their own home or that of a relative, a nursing home or assisted living facility, or retirement community. Some hospices offer inpatient services in dedicated hospice facilities.
- Palliative care is most often done in the hospital setting or at home.