Family and Friends

How Do I Know When My Loved One Needs Hospice or Palliative Care?

Hospice worker with mask talking to elderly patient
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When a loved one has a serious illness, you want to find the right care. However, there can be confusion about two similar care approaches: hospice care and palliative care. We asked our own Suzanne Karefa-Johnson, MD, a hospice doctor at AdventHealth, to explain the difference between hospice and palliative care.

Hospice care and palliative care are very similar when it comes to the important issue of caring for patients who are dying, says Dr. Karefa-Johnson.

Its a way of providing comfort to patients with life-limiting illnesses. Where palliative care programs and hospice care programs differ greatly is in the care location, timing, payment, and eligibility for services.

So, what is palliative care?

Palliative care is specialized medical care for people living with a serious illness that focuses on providing relief from the symptoms and stress of that illness. The goal is to improve your quality of life and that of your family. Palliative care patients can be any age and at any stage in a serious illness, and they can receive palliative care along with a curative treatment.

How is palliative care different from hospice care?

While both palliative care and hospice seek to provide pain and symptom relief, the reasons tend to be different. Hospice, which is sometimes called end of life care, offers comfort care without trying to cure your condition, either because there are no longer any ways to cure it, or you've decided to stop treatment. Palliative care, on the other hand, provides comfort care with or without the intention to cure you. It doesn't hurry or postpone death but rather guides you and your loved ones along this final journey. Hospice patients are facing end of life situations, while palliative care patients may be dealing with a serious, but ultimately curable, condition.

Hospice patients are no longer being treated for their illness because they're at the end stage of their lives, while palliative care patients may not be terminal and may still find benefits from curative treatment, explains Dr. Karefa-Johnson.

Where do patients receive hospice care? Where do they receive palliative care?

Hospice care is given wherever you are, including hospice care at home, in hospice residences (where available), nursing homes, assisted living facilities, veterans' facilities, and in hospitals. Palliative care teams typically work in hospitals but palliative care at home may be an option.

Who makes up the hospice care team and the palliative care team?

Both hospice and palliative care are given by teams made up of diverse specialists who support your whole well-being. The physical, emotional, and spiritual needs of both you and your family are provided for by a physician-directed and nurse-coordinated team approach to care, along with the daily primary care offered by loved ones.

In addition to a physician and nurse, other members of the hospice care team include a social worker, non-denominational chaplain, certified nursing assistant, trained volunteer and bereavement counselor. This team goes to wherever you are, whether it's at home, in a nursing home or assisted living facility, or hospital. The palliative care team is provided by palliative care doctors, nurses, social workers and others who work together with a patients other physicians to provide an extra layer of support. Palliative care teams mostly work in hospitals.

How do we pay for hospice or palliative care?

Hospice is paid 100 percent by Medicare, Medicaid and private insurance. This Medicare benefit includes medications, equipment, access to care, nursing, social services, chaplain visits, grief support following a death, as well as other services.

Palliative care, on the other hand, is paid for by insurance, by the patient or sometimes by a charity.

Is there a difference in who can receive hospice or palliative care?

To be eligible for the Medicare hospice benefit, you must have two physicians certify that you've less than six months to live if the disease follows its usual course.

Palliative care is begun at your discretion and that of your physician at any time, at any stage of illness, terminal or not.

Palliative care is a crucial part of any medical treatment plan because the goal is providing relief from symptoms like pain for patients with serious illnesses, explains Dr. Karefa-Johnson. You should talk to your family and doctors about what your goals of care are and if palliative care and/or hospice care might be right for you.

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