Palliative Care And Hospice Care

 

As hospice care providers we often see or hear the terms palliative care and hospice care used interchangeably even though they are not exactly the same thing.  

While these two services do share things in common, there are distinct differences. Knowing and understanding what each healthcare service offers helps you to make the most informed healthcare decisions for yourself or a loved one.

What Palliative Care And Hospice Care Have In Common 

Here are some of the things that palliative and hospice services have in common. 

Specialists at the helm 

Both are special niches of the healthcare arena. Palliative and hospice care physicians, nurses, and social workers have a particular calling that leads them to their careers. We won’t dwell on this but we feel it is worth pointing out. Both the hospice and palliative care realms support patients and their families as they create and amend care plans that improve quality of life while coping with terminal or chronic health conditions. 

Compassionate comfort care 

Both of these healthcare services are designed to provide compassionate comfort care, rather than curative care.   So, while you may be living with kidney disease, cancer, or other chronic health conditions, your primary physicians and specialists are still the ones you’ll rely on for specific treatments or curative medications, trials, or therapies.  Some of the most common conditions that lead to a physician’s referral to palliative care or hospice include: 

• Congestive Heart Failure (CHF) 
• Chronic Obstructive Pulmonary Disease (COPD) 
• End State Renal Disease (ESRD) 
• Liver Failure 
• Neurological/Stroke 
• Dementia/Alzheimer’s 
• Cancer 
• HIV/AIDS 
• Amyotrophic Lateral Sclerosis (ALS) 

Comfort care plans are designed to support you as you navigate the pain, agitation, discomfort, side effects, etc., that result from your medical diagnosis or from the side effects of medications, treatments, or physical limitations.   That said, palliative care plans work in tandem with current healthcare plans and practitioners but do not supersede them. Hospice care takes over from your primary or specialist care team 

The combination of physical, mental, and emotional relief

Compassionate comfort care may look as simple as a hospital bed set up in your home to help you with position changes or to minimize bedsores. It might also look like oxygen, massages, or respiratory treatments that aid breathing. Those are all examples of the physical care offered by both palliative and hospice care teams.  Your physical palliative and hospice care plans will address associated effects of your diagnosis or medications such as: 

• Pain 
• Shortness of breath 
• Fatigue 
• Anxiety 
• Depression 
• Lack of appetite 
• Nausea 
• Constipation 
• Anything else that affects the physical body 

Then there are the mental and emotional aspects of chronic illness, which include: 

• Stress 
• Anxiety 
• Depression 
• Loneliness 
• Doubts about religion/spiritual life 
• Etc. 

Social workers and an extensive network of professionals provide mental and emotional support to patients and families as well, creating a holistic support system. 

How They Are Different 

Here are some of the ways palliative care and hospice care are different 

Comfort care during treatment vs during the end of life 

One of the best ways to remember the similarities and differences in these two models of care is to consider that the objectives of palliative care and hospice care are the same: to offer pain relief, ease symptoms, and provide peace of mind. However, the goals of care tend to be different.   Patients taking advantage of palliative care may be facing the effects of a chronic illness but have years or decades of life ahead of them. Hospice patients, however, have opted to cease curative treatment. For some, there are no curative options available. Others feel their treatment plan compromises the quality of life in a way that takes away from the time they have left.  Read our post, What is Hospice Care, to learn more about the hospice specifics.   Palliative care provides comfort care with or without curative intent. Hospice care is not cure-oriented; it is designed to provide comfortable care and resources as a patient approaches the end of his/her life. Hospice care is chosen when cures and treatments are no longer an option because the negative side effects of curative approaches outweigh the benefits of the treatment.  

Hospice care means forgoing treatment  

Hospice patients have decided they don’t want any more curative treatments. So, cancer patients undergoing chemo or radiation would pursue palliative care, while those who are tired of treatments or opt not to pursue them would go the hospice care route. Palliative care patients often transition to hospice care when their condition becomes terminal or they make the decision to cease treatment.  On the flip side, we’ve also had hospice patients that fare so well once they have an extensive hospice support network that they shift off of hospice care to pursue treatment for a while. Typically, though, hospice clients have a healthcare condition with a prognosis of six months or less. That said, hospice service can be renewed again and again if clients outlive the prognosis.  

How palliative care and hospice care are paid for 

Palliative care is only paid for by your health insurance provider or your personal finances. If you are 65-year or older, Medicare may pay for a portion of palliative care costs but patients are personally responsible for the remaining costs billed by your hospital or healthcare provider.  Hospice care is a federally-funded program. All costs are completely covered by Medicare and/or your insurance provider (who pursues reimbursement through Medicare). That is one of the reasons why hospice has stringent qualifiers and an incredible network of healthcare professionals and volunteers that provide a holistic care model. 

The location of care 

Palliative care is part of the hospital or HMO network, so most patients meet with their palliative care team at a hospital, clinic, or specialist’s offices. It is not typically a home-based service, nor are their palliative care centers or homes.  Hospice care brings the care to the patient, wherever s/he may be. For some, this is in a hospital, acute care, or assisted living facility. For others, hospice care takes place in a local hospice house or in the comfort of the patient’s own home.  Visit our post, Hospice Care at Home…to learn more about the pros and cons of hospice care at home versus in healthcare or hospice home settings.

Wondering Which Is Right For You Or A Loved One?

Are you currently deciding between palliative and hospice care options? Reach out to Hospice of the Golden Isles. (912) 265-4735. We offer both types of care and can help you determine which one makes the most sense for your diagnosis, daily experience, and your current concerns and we’ll take it from there. Let us do all of the planning for you, so you can get back to the important work of enjoying the best quality of life possible.