Hospice Care and Palliative Care: What’s the Difference?
Hospice Care is defined as care in the home for patients with a terminal illness. Examples include cancer, congestive heart failure, Alzheimer's disease, and end-stage kidney disease. The physician estimates the patient to have 6 months or less to live. The patient is no longer seeking aggressive treatment for the disease, but has chosen comfort care. Hospice is for all ages. Anyone can refer a patient for Hospice. A doctor’s order is required, and the doctor has to follow Hospice regulations and other guidelines. Hospice patients do NOT have to be homebound. Hospice helps guide patients and their families through the process, and patients choose what they want for care.
All Medicare patients automatically have a Hospice benefit. Many private insurances have the Hospice benefit also. When on the Hospice program, patients receive the support of:
A team consisting of RN, Social Worker, Chaplain, Home Health Aide, volunteers, and a Bereavement Counselor.
When on the Hospice program, Medicare pays a daily rate for care provided, including the above. Hospice also has a Respite benefit so a patient can be placed in a care facility up to 5 days if family caregivers need a break or are ill. The Hospice team arranges the transfer/placement. Another service is that it Hospice cannot control a symptom in the home environment, the patient can be hospitalized, and Hospice would cover this admission, including transportation. Most of the time, the skilled RNs can manage symptoms in the home.
Hospice also provides a bereavement service to those grieving the loss of the patient for up to 13 months following the death. Many special events are available, if people choose to participate, including memorials and children’s groups.
Palliative Care is available for patients who would otherwise “fall through the cracks” of the healthcare system. They may not be homebound, or they may not quality for Home Health because they have more than a limited need for nursing care. They may not quality for Hospice because they are expected to live with their condition longer than 6 months. They may have a terminal illness, but are choosing to treat it aggressively. They may not be getting better, but may be living with difficult health problems for a long time. Examples of diagnoses include diabetes, Parkinson's disease, emphysema, and MS. The patient could have multiple problems associated with aging.
Palliative Care is available to all ages. The patient does not have to be homebound. A doctor’s order is still required. The services available on a palliative care program are:
“people services” only, including RN, Social Worker, Home Health Aide, and volunteers. There is currently no reimbursement for palliative care, and Unity is the only organization with a palliative care program.
Many patients choose Palliative Care for assistance with bathing and medication set-up, and feel the added security of having a nurse available to them. They also enjoy the social worker visits, and help with future plans.
