The What/Why/Who/Where of Hospice and Palliative Care
As the medical power of attorney for my 97-year-old father, I am often asked if I want to switch him from In-Home Care to Hospice or Palliative Care. I have had to weigh the differences and try to decide what is best for him as he ages and goes through various health crises.
Dad currently lives in an assisted living center that provides a high level of care for its elderly residents, but we outsource his oxygen provider, and we have a Home Care Agency that handles his diabetic care and comes in three times a week to shower and shave him. These services are paid for by Medicare. My primary dilemma has been over his diabetic care, which is not included with hospice and strictly palliative care. In Utah, he could switch to hospice care at any time and stay where he is, but that varies from state to state.
Perhaps you or a loved one will be put in the position of having to make a decision similar to mine. When that time comes, the more information you have about each type of care, the easier your decision could be regarding what will provide the services you will benefit from the most. There are many resources you can turn to for information, including DTN Home Care, but here is a brief overview to get you started.
What are hospice and palliative care?
Hospice care provides medical services, emotional support, and spiritual resources for people who are in the last stages (six months or less to live) of a serious illness, such as Alzheimer’s, cancer or heart failure. Hospice care also provides support for family members that help them manage the practical details and emotional challenges of caring for a dying loved one. Hospice and palliative care both focus on addressing issues causing physical or emotional pain, or suffering. The goal is to keep you comfortable, and to improve your quality of life vs. continuing with treatment to prolong your life.
Some hospice providers offer palliative care as a separate program or service, which can be very confusing to patients and families. Click on this link to access a list of questions that includes answers to common questions about the difference between hospice and palliative care.
What services are provided under hospice care?
Common hospice services include:
- Basic medical care, with a focus on pain control and providing comfort measures.
- Access to a member of your hospice team 24/7.
- Medical supplies and equipment that are needed for comfort but not curative care.
- Counseling and social support to help with psychological, emotional, and spiritual issues.
- A break (respite care) for caregivers, family, and others who regularly provide care.
- Volunteer support, such as preparing meals and running errands.
- Counseling and support for family members after a loved one dies.
Why choose hospice care?
During the last stages of a serious illness, many patients and caregivers feel that they have lost control over their lives and over what will happen to them or their loved ones. Hospice care can provide options that could give you more control. It can help you to make decisions related to end-of-life care that are important to you. It can help the dying to be more comfortable and also provide comfort, emotional and even spiritual help. However, it is important to know and understand the services your hospice provider offers, as they are not all exactly the same.
Who is on a hospice care team?
In addition to a doctor and nurses, hospice teams usually include:
- Social workers.
- Medicine specialists.
- Spiritual advisers.
- Nursing assistants.
- Trained volunteers.
Some hospice teams may also include respiratory, music, physical and occupational therapists; pharmacists; psychologists and psychiatrists. Some people worry that they will lose the care of their regular, trusted doctor. But he or she can work with the others on your team and stay involved in your care.
Who is eligible for hospice services?
Usually, these two things must be true in order to be eligible:
- You or your loved one has a terminal illness that cannot be cured.
- Your doctor expects you to live six months or less, if your illness runs its normal course.
People who live longer than six months can be re-evaluated for eligibility to continue with hospice care. If the illness gets better, patients may no longer qualify for it. Hospice care is generally paid for by Medicare, Medicaid, and private insurance. Care also may be available to those unable to pay.
Where is hospice and palliative care available?
Hospice care can be provided in your home. Family members or loved ones may provide much of the daily care that is needed. The hospice team will work with them to help give the best care possible. A member of your hospice team may visit you for an hour or so once a week or more, as needed. Hospice programs also may offer services in a hospice center, nursing homes, long-term care and assisted living facilities, or hospitals. The choice of locations may vary from state to state.
For more information on where you can obtain hospice and palliative care, contact DTN Home Care or a local hospice provider.
by Marti Lythgoe, DTN Home Care Writer/Editor
This blog is not intended to be medical advice. Please contact your own team of specialists.
- Palliative care