Understanding Hospice Care: Key Differences Between Hospice and Palliative Care
Navigating end-of-life care options can be overwhelming for patients and their families. While both essential, hospice and palliative care are often misunderstood, leading to confusion about their distinct purposes and benefits.
In this blog, we'll explain hospice care and explore the key differences between hospice and palliative care, equipping you with the knowledge to make informed and compassionate decisions during these challenging times.
What is Hospice Care?
Hospice companies focus on comfort and quality of life for patients nearing the end of life. It is typically offered to patients with a prognosis of six months or less and begins with a doctor's referral and an initial assessment by a hospice team.
The primary goal is to manage pain and other symptoms, ensuring the patient can live their final months with dignity and as comfortably as possible.
What Services Does Hospice Care Provide?
Hospice care includes a comprehensive range of services including:
Pain and Symptom Management: Comprehensive care by a hospice nurse to alleviate pain and manage symptoms.
Emotional and Spiritual Support: Counseling and support for the patient and their family by hospice social workers and chaplains.
Support for Family Members: Guidance and bereavement support for family.
Respite Care for Caregivers: Short-term relief for in-home caregivers.
Medical Equipment: Many expenses associated with the illness including all medications related to the condition, durable medical equipment (DME) like a hospital bed, wheelchair, and oxygen, are provided and covered under Medicare Part A, as long as it's needed for quality of life.
Who Qualifies for Hospice?
Hospice care is generally for patients with terminal illnesses who have a prognosis of six months or less to live if the disease follows its natural course. Patients must forgo curative treatments and choose care focused on comfort and quality of life. A doctor must certify that the patient meets these criteria.
Who Makes up the Hospice Team?
The hospice team typically includes a variety of healthcare professionals and support staff, including doctors, nurses, social workers, chaplains, home health aides, therapists, and trained volunteers. This interdisciplinary team collaborates to create and implement a care plan tailored to the patient's needs and wishes.
What Role do Volunteers Play in Hospice Care?
Volunteers are an essential part of hospice care. They provide companionship to patients, offer respite to family caregivers, assist with household tasks, and help with administrative duties. Volunteers may also provide emotional support and engage in activities that enhance the patient's quality of life.
Where is Hospice Care Provided?
Hospice care can be provided in various settings, including the patient's home, hospice centers, assisted living communities,hospitals, nursing homes, along with other settings. The hospice team offers regular visits, but not daily (this varies on the hospice company and the individual patient needs), and 24/7 on-call support. To meet these needs, numerous local providers, such as Crater Hospice or Suncrest Hospice offer compassionate and professional services to those considering hospice care in Richmond, VA.
What is Palliative Care?
Palliative care is designed to improve the quality of life for patients with serious illnesses at any stage, not just at the end of life. A serious illness is a disease or condition that can lead to death or significantly impact a person's quality of life and ability to do everyday tasks. It often causes symptoms or requires treatments that disrupt daily life.
A Palliative care provider will meet with a patient to assess their needs more as coordination of care. They look at patients' primary diagnosis and additional comorbidities (presence of two or more diseases or medical conditions) to come up with a plan of care to provide symptom relief.
What Services Does Palliative Care Provide?
Unlike hospice care, palliative care can be provided alongside curative treatments. Services offered in palliative care include:
Pain and Symptom Management: Relief from the symptoms and stress of the illness.
Emotional and Spiritual Support: Helping the patient and family cope with the illness's emotional aspects.
Coordination of Care: Ensuring smooth communication and care planning among different healthcare providers.
Medical Supplies and Services: The plan of care often includes DME, physical therapy, occupational therapy, medication management, skilled nursing, and prescriptions. Each one of these items would be a separate home health order and are subject to eligibility and applicable copays.
Support for Family Members: Offering resources and counseling to help families navigate the healthcare system. Social work is often included to address psychological/social issues like Family and Medical Leave (FMLA) or accessing additional community resources.
Where is Palliative Care Provided?
Palliative care can be administered in hospitals, outpatient clinics, nursing homes, assisted living facilities, or at home, providing flexibility and support throughout the course of the illness.
Who Provides Palliative Care?
Palliative care is provided by a team of specialists, including palliative care doctors, nurses, social workers, nutritionists, and other healthcare professionals. This team collaborates with a patient's other doctors to provide extra support, focusing on relief from symptoms and stress related to the illness.
Does Using Palliative Care Mean I'm Dying?
No, using palliative care does not mean you are dying. Palliative care is appropriate at any stage of an illness and can be provided alongside curative treatments. Its goal is to improve quality of life by managing symptoms and providing emotional and psychological support.
Should I Include Palliative Care in my Advanced Care Planning?
Yes, including palliative care in your advanced care planning can be very beneficial. It ensures that your preferences for managing symptoms and receiving support are documented and respected, regardless of the stage of your illness.
How Does Hospice Care Differ From Palliative Care?
While both hospice and palliative care focus on providing comfort and improving quality of life, hospice care is specifically for patients nearing the end of life, typically with a prognosis of six months or less.
Here are the key differences between hospice and palliative care:
Goals of Care:
Hospice Care: Focuses on comfort and quality of life without curative intent.
Palliative Care: Aims to relieve symptoms and improve quality of life, potentially alongside curative treatments.
Duration and Continuation of Care: Crater Hospice or Suncrest Hospice
Hospice Care: Generally for patients expected to live six months or less. Hospice providers come out on average 2-4 days a week and are added support for the existing care team.
Palliative Care: Can be long-term, beginning at diagnosis and continuing through the course of the illness. Palliative care itself is not day to day as appointments are usually once or twice a month.
Payment and Insurance Coverage:
Hospice Care: Often covered by Medicare, Medicaid, and private insurance. Hospice is covered under a patient's Medicare Part A. There is typically no copay association with traditional medicare plans or advantage plans.
Palliative Care: Coverage varies but is often integrated into broader medical care plans. Palliative Care is covered under Medicare part B and is subject to copays and out of pocket expenses.
When to Choose Hospice Care
Deciding when to consider hospice care can be a difficult decision, but understanding the right time can bring significant comfort to both patients and their families.
Hospice care is typically considered when a patient has a life-limiting illness with a prognosis of six months or less if the disease follows its expected course. This care focuses on enhancing the quality of life, managing pain, and addressing physical, emotional, and spiritual needs.
When curative treatments are no longer effective, and the focus shifts to comfort and dignity, hospice care should be considered. Early consideration can ensure that the patient receives comprehensive care tailored to their needs, providing more ease and comfort for family members as well.
When to Choose Palliative Care
Palliative care is suitable for patients diagnosed with a serious, chronic, or life-threatening illness who are experiencing ongoing symptoms that affect their quality of life. It is also ideal for those who need coordinated care across multiple specialists.
The benefits of palliative care include:
Improved symptom management.
Enhanced overall quality of life.
Support for making complex medical decisions.
It's a supportive approach that complements ongoing medical care, offering holistic support and guidance tailored to the individual's needs and preferences.
Conclusion
Both hospice care and palliative care provide valuable services that focus on the quality of life, but they are tailored to different stages and goals of patient care. Knowing the difference between the two models of care is essential.
Discussing these options with healthcare providers can help ensure that patients receive the most appropriate and compassionate care possible.
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