St. Gabriel's Hospice and Palliative Care

What is the Difference between 'Hospice' and 'Palliative' Care?

'Hospice care' and 'palliative care' are not synonymous, nor, are they mutually exclusive.  Both options call for a patient to receive an individual program made up of a variety of services.  Both hospice care and palliative care utilize a multi-disciplinary, team-based approach where patients can receive daily care, medications, the use of medical equipment, bereavement counseling, and symptom treatment.

The real differences between hospice and palliative care include 1) the location of the care services 2) the duration of the illness 3) payment 4) treatment 5) eligibility for services.  But let's break down the differing components of hospice and palliative care a bit more thoroughly.

Location of Services

Hospice-care programs are much more common than palliative-care programs; and hospice care, more often than not, takes place in the home.  Other facilities may, on occasion, provide 24/7 hospice care; but this would be the exception rather than the rule.  Hospice care, itself, is overseen by a team of hospice professionals who depend on the family care-giver and a visiting nurse to maintain the administration of medications and other vital components of care. 

Palliative care usually occurs in a hospital, extended-care setting, or nursing home – wherever the patient, initially, receives treatment.  Unlike hospice care, palliative-care patients receive their comfort care from doctors, nurses and a variety of other medical professionals at the patient's care facility.

Duration of the Illness

One salient difference between hospice and palliative care is the duration of the illness.  To be eligible for hospice care, a patient will have received a prognosis of being terminally ill or be within 6 months of the end of life.  Hospice benefits from one's insurance company are determined by these timing factors.

Palliative care is not determined by the duration of a patient's illness; and palliative-care can be administered at any time as well as during any stage of illness.  Additionally, an illness does not, necessarily, need to be terminal to allow eligibility for palliative services. 

Payment

With both hospice and palliative care, it is very important to contact insurance companies to, clearly, determine what services may or may not be covered.  Hospice can be deemed an 'all-inclusive' treatment; and though hospice programs cover virtually all the treatment costs, insurance coverages may vary.  Hospice does offer subsidized care for those who are financial challenged or for patients who are not covered under their own insurance.  Patients covered under Medicare will, often, have access to hospice programs.

Palliative care is, commonly, covered by a patient's regular medical insurance.  An important point to remember is that each item used during palliative care, whether it is a medical device or prescriptions, etc., is billed separately.

Treatment

With hospice care, the focus is on a patient's comfort vs. aggressive medical interventions.  Though curative or life-prolonging treatments are not, usually, a chosen component of hospice care; some hospice programs will offer life-extending therapies.  Optimal care and comfort – physically, emotionally, spiritually, and socially – are designed to improve the quality of life of the patient's remaining time. 

Palliative care, more commonly, utilizes curative or life-prolonging therapies; though some palliative programs focus on end-of-life care, only.

Eligibility

Hospice care eligibility involves three main considerations where the patient must:  1) be officially certified as terminally ill by the primary-care physician and hospice medical director 2)  accept comfort care measures and agree to not pursue curative interventions 3) elect to utilize hospice care with a specialized hospice organization.

With palliative care, eligibility is much simpler:  the patient must request palliative-care referral from a physician.  This request can take place during any stage of the patient's illness.

The most important issue with, either, hospice care or palliative care is the fact that patients and the patients' loved ones are the recipients of the utmost compassionate comfort and care

 

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