If an aging loved one starts to need more medical support than they used to, you might find yourself researching your friend or family member’s medical care options. Your research will most likely lead you to read a lot about palliative and hospice care. If you’re new to end-of-life care options, these terms may be unfamiliar.
In this article, we’ll examine:
- What palliative care is
- What hospice care is
- How to decide what palliative and hospice care provider to pick
Dr. Ismael Roque-Velasco, president and CEO of OpusCare, says that, in general, a quality hospice and palliative care program is created and maintained with thorough staff training. “Having a team specifically trained in the hospice philosophy is essential to providing high-quality compassionate care,” Roque-Velasco adds. Considering this, among other aspects that I address in this piece, will help you determine the best type of care provider for your loved one’s needs.
What is palliative care?
According to The National Hospice and Palliative Care Organization (NHPCO), “palliative care is a specialized approach to the treatment of patients with a serious or life-threatening illness.” Some of these illnesses include (but are not limited to):
- Cancer
- Lung and heart disease
- Dementia
- End-stage renal disease
- Liver disease
- ALS
- HIV/AIDS
The NHPCO adds that “The goal of palliative care is to provide relief from the symptoms, pain, and stress of serious illness” while improving the patient and patient’s family’s quality of life. Roque-Velasco adds that when a patient is in a palliative care program, they still receive curative care.
A typical palliative care team includes:
- Physicians
- Nurse practitioners
- Social workers
- Spiritual care coordinators
The NHPCO also notes that some palliative care teams also “have physical and speech therapists, pharmacists, dieticians and trained volunteers.”
What is hospice care?
The NHPCO states that a hospice’s focus is on “caring, not curing.” So, hospice care is available to “any person who has a life-threatening or terminal illness.” Most reimbursement sources for hospice care “require a prognosis of six months or less if the illness runs its normal course. All hospices consider the patient and family together as the unit of care.”
Although most hospice care occurs in a person’s home, care also can take place in:
- A freestanding hospice center
- Hospital
- Nursing home
- Long-term care facility
The NHPCO adds that “hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.”
In general, hospice care is provided by a team of people with a loved one’s family member or friend serving as the “primary caregiver.” The primary caregiver is the individual who is tasked with making “decisions for the terminally ill individual.” The “outside” hospice team is a team of professionals (who typically are available 24 hours a day, 7 days a week) and volunteers.
Hospice professionals include:
- A patient’s personal physician
- A hospice or medical doctor
- Nurses
- Home health aides
- Social workers
- Spiritual care providers or other counselors
- Bereavement professionals
- Speech, physical, and other occupational therapists
- Trained volunteers
How to decide what palliative care provider is right for your loved one
UCLAHealth.org has published a list of questions to help people determine what palliative care program will meet their loved one’s needs. Each question on this list considers a program’s admissions criteria, setting, staffing, volunteer program, family involvement and support, comfort and pain management services, contracts with other facilities and providers, and additional palliative care services.
When deciding on a palliative care program, it’s also important to consider where programs provide care and if the care is covered. The National Institute on Aging (NIH) says that palliative care can occur in nursing homes, hospitals, specialized clinics, patients’ homes, and outpatient care clinics. “Medicare, Medicaid, and insurance policies may cover palliative care,” the NIH adds.” Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance might pay for some services.”
How to decide what hospice provider is right for you
The NHPCO explains that choosing a hospice care provider is personal. However, a person can gain insight on providers to consider by doing the following:
- Call hospices in your area and ask what type of services they provide the patient, the primary caregiver, and the patient’s family.
- Talk to a physician and ask for recommendations.
- Talk to other professionals in the hospice care industry, such as social workers, clergy, spiritual professionals, death doulas, etc.
- Ask people you know who have experience with the hospice care system.
The NHPCO also recommends consulting worksheets (such as this one) to help you narrow down the hospice provider that’s right for your loved one. Also, consider visiting the CMS Compare website once you’ve narrowed down your hospice selections.
