The Importance of early Hospice Care

The differences between hospice and palliative care.

Most people are frightened when they hear the word “hospice”. They immediately think of death, but in my experience, hospice was a lifesaver when both my parents became ill. Because of the negative feelings that this word invokes, most people wait way too long to sign on to this life giving, life saving service for their loved ones that is provided at no cost to you! My parents were terminally ill for over a year and I was so glad that I didn’t wait to call on Samaritan hospice to help me care for them. I was their sole caregiver in the family and had help from a home health care agency.   At the end of their journey, it was increasingly difficult to keep up with the demands of caring for them and that is when hospice will step in to relieve some of the burdens. I especially appreciated them coming in to bathe my mom every day. Although she was quite frail, it was very difficult to maneuver her to get her into the shower. A loving aid came in every day to shower her and in the end, sponge bathe her in the bed. The day before they died, the care was so intense that they transferred both of my parents to their in- patient facility in Mt. Holly. They took such loving care of my parents so that they could die with peace and dignity in a cozy, non-hospital setting. Shortly after they died, the new facility in Voorhees opened and it is absolutely gorgeous. It is such a great place to help you through your loved ones final hours.

Hospice care and palliative care are very similar when it comes to the most important issue for dying people: which is care. Most people have heard of hospice care and have a general idea of what services hospice provides. What they don’t know or what may become confusing is that hospice provides “palliative care,” and that palliative care is a method of administering “comfort” in a hospital setting or at home. As an adjunct or supplement to some of the more “traditional” care options, both hospice and palliative care call for patients to receive a combined approach where medications, day-to-day care, equipment, bereavement counseling, and symptom treatment are administered through a single program. Where palliative care programs and hospice care programs differ greatly is in the care location, timing, payment, and eligibility for services.

Hospice

Hospice programs far outnumber palliative care programs. Once enrolled through a referral from the primary care physician, a patient’s hospice care program, which is overseen by a team of hospice professionals, is administered in the home. Hospice often relies upon the family caregiver, as well as a visiting hospice nurse. Hospice can provide round-the-clock care in a nursing home or a specially equipped hospice facility like the new Samartian Hospice facility recently opened in Voorhees.

Palliative Care

Palliative care teams are made up of doctors, nurses, and other professional medical caregivers, often at the facility where a patient will first receive treatment. These individuals will administer or oversee most of the ongoing comfort-care patients receive. While palliative care can be administered in the home, it is most common to receive palliative care in an institution such as a hospital, extended care facility, or nursing home that is associated with a palliative care team.

Timing:

Hospice

You must generally be considered to be terminally ill or within six months of death to be eligible for most hospice programs or to receive hospice benefits from your insurance.

Palliative Care

There are no time restrictions. Palliative care can be received by patients at any time, at any stage of illness whether it be terminal or not.

Payment:

Hospice

Before signing up for a hospice progam be sure that you are working with one that is of a non profit status. These programs are covered by most insurance and the overage is absorbed by Hospice. Hospice depends on grants and donations so that they can care for anyone that needs help, no matter what their financial status is. Many hospice programs are covered under Medicare as well.

Palliative Care

Since this service will generally be administered through your hospital or regular medical provider, it is likely that it is covered by your regular medical insurance. It is important to note, however, that each item will be billed separately, just as they are with regular hospital and doctor visits. If you receive outpatient palliative care, prescriptions will be billed separately and are only covered as provided by your regular insurance. In-patient care however, often does cover prescription charges. For more details, check with your insurance company, doctor, or hospital administration.

Treatment:

Hospice

Most programs concentrate on comfort rather than aggressive disease abatement. By electing to forego extensive life-prolonging treatment, hospice patients can concentrate on getting the most out of the time they have left, without some of the negative side-effects that life prolonging treatments can have. Most hospice patients can achieve a level of comfort that allows them to concentrate on the emotional and practical issues of dying.

Palliative Care

Since there are no time limits on when you can receive palliative care, it acts to fill the gap for patients who want and need comfort at any stage of any disease, whether terminal or chronic. In a palliative care program, there is no expectation that life-prolonging therapies will be avoided.

It is important to note, however, that there will be exceptions to the general precepts outlined. There are some hospice programs that will provide life-prolonging treatments, and there are some palliative care programs that concentrate mostly on end-of-life care. Consult your physician or care-administrator for the best service for you.

One of the most important aspects of Hospice is that they provide comfort to patient and also support for the caregiver. Caring for a terminally ill family member is no small task. It is vital that you make hospice part of your team.

Reprinted from “Hospice vs. Palliative Care,” by Ann Villet-Lagomarsino. Educational Broadcasting Corporation/Public Affairs Television, Inc. Reprinted with permission.   www.caringlibrary.org