Palliative Care and Hospice often get confused with each other, and they also have a lot of negative connotations. We break down what you need to know, and help you figure out how to use each service to the fullest.

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4 MAIN DIFFERENCES AT A GLANCE

1. Prognosis – Palliative care does not have a particular prognosis. Hospice requires a prognosis of less than 6 months to live.
2. Qualifying for Care – Palliative care requires a serious illness, acute or chronic, as determined by your physician.
3. Goal of care – Palliative care focuses on quality of life during treatment. Hospice care focuses on quality of life and comfort measures without treatment for a disease or illness (unless that treatment will provide symptom relief)
4. Oversees Care – Palliative care is typically overseen by your normal PCP (primary care physician) while hospice care is overseen by the Medical Director of the Hospice.

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WHAT IS PALLIATIVE CARE?

Palliative care is specialized medical care for those with serious illnesses. The entire focus of palliative care is to increase quality of life, which is different for every person.

MYTH BUSTER: You don’t have to be “end-of-life” and you don’t have to be actively dying to receive palliative care.

• Prognosis (probable outcome because of your diagnosis) –  There is no prognosis qualification for palliative care.
• Qualifying for care – You must have a chronic or acute condition that interferes with quality of life or ability to do Instrumental Activities of Daily Living (IADLs) or Activities of Daily Living (ADLs).

• Goal of care – The goal of palliative care is to provide relief from the symptoms and stress of a serious illness. Palliative care focuses on improving the quality of life during treatment.
• Who oversees the care – Your primary care physician typically oversees palliative care.
• Who provides the care – Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home.

Medicare, Medicaid, and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance might pay for some services. Health insurance providers can answer questions about what they will cover. Private pay options are available for services that may be incorporated into a palliative care plan like massage, hypnotherapy, hyperbaric therapy, etc.

How to use palliative care to its fullest:

1. Ask your doctor for resources for the best palliative care options in your area.
2. If your doctor or practitioner don’t know of any, do online searches for “Palliative Care <insert your area’s name>” or look at this directory to see if there is anyone in your area. An example in Delaware is Delaware Transitions. Most companies like this have services that are completely free of charge!
3. Call your insurance company and ask for all the services that your insurance covers for palliative care. Some of the services that are often covered by insurance may include: supplies, nursing services, social work services, or spiritual visits.

Examples of when to use Palliative Care:

• Congestive Heart Failure
• Chronic Obstructive Pulmonary Disease (COPD)
• Cancer
• Dementia
• Parkinson’s
• Multiple Sclerosis
• Any diagnosis that can limit your quality of life and/or ability to do ADL’s or IADL’s.

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WHAT IS HOSPICE?

Hospice is a type of care that is enlisted for patients with less than 6 months to live. It offers patients pain relief, nursing care, emotional support and help with everyday tasks.  Hospice can also provide support for family, friends, and caregivers as they too are on this journey with the patient. Hospice does not seek a cure

MYTH BUSTER: You can “graduate” from hospice. In some cases, patients improve and no longer meet the requirement for hospice care. Read more here.

• Prognosis (probable outcome because of your diagnosis) – General guidelines for health providers to qualify an individual for hospice is less than 6 months to live.
• Qualifying for care – An individual must be considered terminally ill, and have less than 6 months to live if the disease runs it’s normal course.
• Goal of care – Comfort measures. When you’re on hospice, all treatment is focused on relief of symptoms, not on finding a cure.

• Who oversees the care – The Hospice Medical Director typically oversees the care
• Who provides the care – Hospice care can be provided in hospitals, nursing homes, outpatient care clinics (or hospice houses, which exist to manage uncontrollable symptoms) and certain other specialized clinics, or at home.

Like palliative care, Medicare, Medicaid, and insurance policies may cover hospice care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance covers some services. Health insurance providers can answer questions about what they will cover. Private pay options are available for services that may be incorporated into a hospice plan like massage, hypnotherapy, hyperbaric therapy, additional home care, grocery shopping, etc.

How to use this service to its fullest:

1. Ask your doctor for resources for the best hospice companies in your area.
2. If your doctor or practitioner doesn’t know of any, do online searches for “Hospice <insert your location>” or look at this directory to see if there is anyone in your area. Examples in Delaware include Compassionate Care Hospice, Delaware Hospice, Seasons Hospice or Heartland Hospice. If your journey of care takes you from one facility to another, these companies can travel with you during the continuum. You will want to ask what the hospice does for uncontrolled symptoms and pain management; some hospices have their own “hospice houses” and some have a wing at a hospital. In our opinion, we have found the hospice houses are typically the best experience for clients and families.
3. Another great research tool is Hospice Compare. It’s a conglomeration of data that helps you find hospices in your area and compare them based on the quality of care they provide.
4. Call your insurance company and ask for all the services that your insurance covers for hospice care. Some of the services that are often covered by insurance may include: supplies, nursing services, social work services, or spiritual visits.

Examples of when to use Hospice Care: Any diagnosis where you may have less than 6 months. You will need a prescription from your physician, so if your doctor hasn’t initiated hospice care, the hospice company can reach out to the physician for you. Hospice consults are free. You can call any hospice company to request one.

You won’t use both palliative care and hospice. You’ll only use one at a time, and any services covered by insurance will only cover one or the other. But by all means, we encourage you to use either of these care services. Most of the services are covered by an insurance, and if you don’t like it, you can always stop. We know experiences vary based on area, company, illness, family dynamics and client needs, but we always encourage you to build up a community that can help deliver quality of life, and palliative care and hospice programs can do just that.

Coming next month, we look at how to pair palliative or hospice care with home care and home health. Until then, we leave you with this challenge: When you hear palliative care and hospice care, think enhanced quality of life, not death.

Silver Lining Home Healthcare is uniquely positioned to provide supplemental palliative and hospice care with a full team of certified and licensed staff. Contact us anytime with questions!

Sources:

“What Is Palliative Care” https://getpalliativecare.org/whatis/

“What Are Palliative Care and Hospice Care?” https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

“Hospice Eligibility Requirements” https://www.nhpco.org/hospice-eligibility-requirements