From Florida Hospital – Apopka
When a loved one has a serious illness, it’s understandable that you want to find the right care. There can be confusion about two similar care approaches: hospice care and palliative care. We asked Suzanne Karefa-Johnson, MD, a hospice doctor at Florida Hospital, 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. “It’s 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 the quality of life for the patient and the patient’s family. Palliative care patients can be any age and at any stage in a serious illness, and they can receive palliative care along with curative treatment.
How is palliative care different from hospice care?
While both palliative care and hospice seek to provide pain and symptom relief, the prognosis and goals tend to be different. Hospice, sometimes called end of life care, offers comfort care without the intention to cure a patient’s condition, either because there are no longer any curative treatment options or the patient has decided to stop treatment. Palliative care provides comfort care with or without the intention to cure the patient. It neither hastens nor postpones death, but guides the patient and their 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 the patient is, 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 interdisciplinary teams who support the medical, emotional, and spiritual needs of both the patient and their family with a physician-directed and nurse-coordinated team approach to care, supplementing the daily primary care provided by loved ones.
In addition to a physician and nurse, other members of the interdisciplinary hospice care team include a social worker, non-denominational chaplain, certified nursing assistant, trained volunteer and bereavement counselor. This team goes to wherever a patient may be: at home, in a nursing home or assisted living facility, and hospitals. The palliative care team is provided by a palliative care doctors, nurses, social workers and others who work together with a patient’s other physicians to provide an extra layer of support. The palliative care team works primarily 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 and other services.
Palliative care is paid for by insurance, by the patient or sometimes by charity.
Is there a difference in who can receive hospice or palliative care?
To be eligible for the Medicare hospice benefit, a patient must have two physicians certify that the patient has less than six months to live if the disease follows its usual course.
Palliative care is begun at the discretion of the physician and patient 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 provide 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.”