Comparing Palliative & Hospice Care

Author

Abode Home Health

Posted on

Mar 06, 2023

Book/Edition

Colorado - Southern Colorado

Some older adults and people with serious illnesses, unfortunately, experience the end of life in certain healthcare settings that do not align with their desired wishes. If you have a serious illness or are a caregiver of someone planning end-of-life care, knowing the difference between palliative care and hospice care can help you make an informed decision when the time comes to transition to one of these healthcare settings.

What Is Palliative Care?

Palliative care is a form of care that focuses on improving your quality of life and that of your family when you are living with a serious illness. It focuses on your whole-person health rather than only on your condition. If you are receiving palliative care, your treatment plan may focus on reducing symptoms of your illness and on improving secondary conditions such as depression, sleep deprivation, and side effects of medications.

Palliative care may be given in various healthcare settings, such as at the hospital, a residential care facility, or your home. Anyone can receive this type of care regardless of age or the severity of their condition.

If you receive palliative care, you may work with and be treated by various healthcare professionals, including doctors, nurses, social workers, pharmacists, physical therapists, counselors, and nutritionists. If you need spiritual care, your palliative care team may even include a chaplain. The healthcare professionals that make up your palliative care team will depend mainly on your recovery needs and level of care.

Studies show that palliative care offers many benefits, including:

  • Reduction in pain, nausea, and shortness of breath
  • Improved communication among patients, their loved ones, and their healthcare providers
  • Increased emotional support
  • High-quality care that aligns with the patient’s wishes
  • Reduction in stress
  • Increased confidence surrounding decision-making related to care
  • Ability to meet the emotional and spiritual needs of the patients and their loved ones
caregiver's hand on patient's shoulder

What Is Hospice Care?

Hospice care focuses on improving your comfort and quality of life when you are nearing the end of your life. This type of care is usually given in circumstances in which an illness continues to progress despite treatment or when the patient chooses not to receive certain treatments. Hospice care is similar to palliative care in that it provides comfort care and support for the family. However, treatments are not given to improve the illness.

Like palliative care, hospice care can be given in many different healthcare settings, though it is most frequently given at your home, where you can be most comfortable and spend quality time with your loved ones. In addition, it is typically given when your healthcare provider believes you have no more than six months to live. Some benefits of hospice care include 24/7 access to nurses and healthcare workers who can address and relieve symptoms and side effects and access to medical equipment and medications that can reduce your discomfort.

Many of the same types of healthcare professionals that make up a palliative care team will also be part of your hospice care team. This includes doctors, nurses, social workers, chaplains, and volunteers who dedicate their time to giving you the support you need and making you feel as comfortable as possible during your final months.

To be eligible for hospice care, you will discontinue aggressive treatment efforts to combat your terminal illness (such as experimental surgeries, aggressive chemotherapy, or other treatments that require prolonged hospitalization and recovery).   However, you may continue to receive treatments for other conditions, such as antidepressants to treat depression or insulin medicines to control Diabetes.   

What Is Comfort Care and End-of-Life Care?

Comfort care and end-of-life care are both terms that describe the type of care you receive when you are near the end of your life and are no longer receiving treatment for your illness. It is highly similar to palliative care in providing you with whole-person care that focuses on your physical, social, emotional, and spiritual health. Comfort care and end-of-life care may include palliative care or hospice care, or a combination of both.

What Are the Main Differences Between Palliative Care and Hospice Care?

Sometimes, palliative care is given as part of hospice care, and both types share many similarities. For instance, the goal of both palliative and hospice care is to improve your quality of life and help you find relief from painful and severe symptoms and side effects of treatment. Both types of care also focus on whole-person health. However, there remain many differences between palliative care and hospice care.

Some of these differences are:

  • Palliative care can be given to anyone with a serious illness, regardless of the stage of their disease. In comparison, hospice care is typically only given when a person has less than six months to live and is at the end of their life.
  • Palliative care can be given simultaneously when the patient receives other treatments for their condition, such as chemotherapy or radiation therapy. Hospice care is usually given when treatment for the illness has stopped, and the goal of care is to manage the patient’s symptoms for the remainder of life.
  • The healthcare professionals on a palliative care team work separately from the patient’s primary care team that is treating the illness. In comparison, the healthcare professionals on a hospice care team handle the majority of the care and collaborate with the patient’s primary care team as necessary.
close up of holding hands with elderly

Who Should Consider Palliative Care?

You may want to consider palliative care if you or your loved one has a serious illness or chronic condition that requires long, intensive care or that causes severe physical symptoms and/or emotional distress. For example, cancer, heart disease, AIDS, and kidney failure are some of the many conditions that can benefit from palliative care.

Additionally, palliative care may benefit you if you:

  • Want relief from severe physical pain you are experiencing due to your illness
  • Are experiencing emotional pain or psychological conditions that you are unable to control
  • Want to continue to receive treatment for your condition
  • Want tips and guidance on how to effectively manage your condition
  • Need guidance with choosing the best treatment
  • Need help understanding your illness
  • Want to receive treatment at home or outside of a traditional hospital setting
  • Have loved ones who are involved with your treatment
  • Need help transitioning from one treatment setting to another

When Would Someone Transition From Palliative Care To Hospice Care?

A person may transition from palliative care to hospice care if their doctor thinks they have no longer than six months to live. Sometimes, it can be difficult for doctors to predict exactly how long it will take for a particular disease to run its course or how long a person has left to live if their health is in decline. In these circumstances, it’s important to consider how transitioning to hospice care could improve your quality of life during your final months.

According to the National Library of Medicine (NLM), doctors should strongly consider referring chronically ill patients to hospice care if they spend more than half their time in bed, are unable to function efficiently, and are experiencing both physical and psychological distress. The NLM adds that hospice referrals are usually necessary when the patient’s condition has progressively declined to the point that their highest priority is to take control of their healthcare and achieve the greatest possible comfort in their homes as they near the end of life.

Talk to your doctor if you think you may need hospice care but aren’t sure when you should transition out of palliative care. Your doctor can talk to you at length about your options and the benefits of transitioning to hospice care based on your condition and unique circumstances.

Taking advantage of hospice care as soon as it’s needed could result in access to quality care and lots of extra quality time to spend with your loved ones. Additionally, studies show that patients who plan their care in advance are more likely to be satisfied with their care, given how they can make decisions that align with their end-of-life wishes.

How to Get Palliative Care or Hospice Care

Consult with your healthcare provider if you or your loved one is interested in learning more about palliative care or hospice care. Your doctor can refer you to a palliative or hospice care specialist who can answer all your questions and help you determine which of these services may be more ideal.

Palliative care and hospice care are covered by many major health insurance providers, including Medicare. The exact benefits covered will vary based on your health plan. Benefits covered may include medical equipment and supplies, skilled nursing care, bereavement support, and medications to provide comfort, among many others.

Hospice At Your Side has resources for home health and hospice services throughout the United States. Specialty services we offer include diabetes care, orthopedics, and pain management. Call us today to learn more about our many home healthcare services.

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How Long Can You Be on Hospice Care?

How Long Can You Be on Hospice Care?One of the most common questions about hospice care is, how long can someone be on hospice? Understanding the duration and criteria for hospice can help patients and their families make informed decisions during challenging times.While most patients only experience its benefits for days and weeks, hospice is available when a patients physician certifies that they have six months or less to live, as explained further below, with recertification available if the patient outlives that six-month period and continues to meet hospice criteria.What is Hospice Care?Hospice is defined as supportive care that focuses on comfort and quality of life. Hospice is available for patients with a terminal illness and a life expectancy of six months or less if their illness runs its normal course, as certified by a physician.Can hospice help?Hospice services include:Skilled nurses making intermittent visits to assess the patient, provide care and coordinate care from other disciplines.Hospice aides to support activities of daily living.Medical social workers to support the patient and family and make connections to community resources.Chaplains for spiritual support.Hospice volunteers for companionship and support.Bereavement support for the family for up to 13 months following the patients passing.Some companies like Amedisys also offer specialized programs to care for certain diagnoses like dementia, heart failure and more. Eligibility Criteria for HospiceUnderstanding how long hospice care can be provided first starts with having a strong grasp of the eligibility criteria.To be eligible for hospice, the patient must be considered terminally ill with a life expectancy of six months or less if the disease runs its normal course, as certified by a physician. The hospice physician uses their clinical expertise and information from a comprehensive assessment to determine life expectancy. Signs the patient is declining from the terminal illness include progressive weight loss, frequency of hospitalizations, increasing weakness or fatigue, difficulty with daily activities and more.The patient must also elect to stop curative treatments in favor of the comfort and quality of life measures hospice provides. The physician will work closely with the hospice care team on a personalized plan of care focused on pain and symptom management and comfort so patients and families can make the most of their remaining time together.How Long Can Patients Receive Hospice Care?Patients can receive the benefits of hospice care as long as they continue to meet the eligibility criteria. If a patient lives longer than the original six-month certification period, physicians can re-certify them to remain on hospice care if the disease progression still indicates a life expectancy of six months or less.Although patients cannot receive curative treatment while on hospice care, if a patients condition improves significantly so that they are no longer considered terminally ill, they will be discharged from hospice care. Patients can also choose to opt out of hospice care at any time during the service.One of the most famous examples of how hospice can extend beyond six months is former President Jimmy Carter. As of this publication, Jimmy Carter has received hospice care for more than a year, spending that precious remaining time with his family in his home. His legacy will be one of normalizing end-of-life conversations, sparking hope that more patients and families will seek out the benefits of hospice and embrace them sooner rather than later.What are the Benefits of Hospice Care?One of the most common phrases we hear from families is, we wish we had chosen hospice sooner. By accepting help early, patients and families can expect a range of benefits at the end of life:Pain and Symptom ManagementPain and symptom management is a central tenant of hospice care, providing comfort and the best quality of life possible for patients at home. Hospice care combines pharmacological and non-medication tactics to manage physical, emotional, psychosocial and spiritual pain for the patient and caregiver.Holistic CareHospice is a unique Medicare benefit providing care with a full, interdisciplinary care team. Holistic care is a patient-centered approach that focuses on caring for the whole person, including their physical, emotional, psychosocial, and spiritual well-being.Supportive Care EnvironmentHaving hospice care at home fosters a sense of security, familiarity and peace, which can contribute to a patients overall sense of well-being.Advance Care PlanningHospice care encourages open communication and advance care planning discussions, allowing patients to express their desires for the final weeks and months of their life. This can help avoid unwanted medical interventions that could diminish quality of life by ensuring patients are getting the care they need and want.How Do You Know When Its Time for Hospice?If youre caring for a loved one with a terminal diagnosis, there are several key signs that it may be time to start talking about hospice care:Their doctor has given a prognosis of six months or less.Their health or disease symptoms are worsening with frequent trips to the hospital or doctors office.They have decreased appetite or pain/nausea interfering with their ability to eat and drink.They sleep more throughout the day and night.There are noticeable behavior changes in mental clarity, confusion, forgetfulness, or irritability.Activities of daily living like feeding oneself, bathing and dressing independently become more difficult.Caregivers are overwhelmed and unable to manage care on their own.What Are the Four Levels of Hospice Care?As you research hospice, you may come across different levels of hospice care. Moving into different levels can be triggered by changing circumstances or needs of the patient or caregiver. Here are the four levels of hospice care all Medicare-certified agencies provide:Routine Home CareThis is the most common type of hospice care. The full team conducts intermittent visits wherever the patient calls home, providing a comfortable and familiar environment.Respite CareRespite care is available when caregivers need a break. Patients are admitted to a long-term care facility or other inpatient facility with 24-hour nursing available. The patient can stay in the facility for up to five days/five nights and returns to routine level of care on day 6. The hospice team coordinates the plan of care and can arrange transport patients to and from the facility as needed.Continuous Home CareThis level of care is for short-term urgent healthcare needs or symptom crises that can still be feasibly addressed at home. The hospice team provides at least eight hours of continuous care within a 24-hour period. When symptoms are controlled, the patient returns back to routine care.General Inpatient CareIf pain and symptoms related to the patients terminal illness can no longer be controlled at home, the patient may be appropriate for General Inpatient (GIP) care. The hospice team facilitates the patients transfer to a hospital, long-term care facility or hospice inpatient unit and will continue coordinating the plan of care. Patients will return home to routine home care once pain and symptoms are managed.How to Get Started with Hospice Care If youre ready to start talking about hospice care with your family, Amedisys is here to support you through every stage. Contact Amedisys Hospice in Mobile, Alabama at 251-343-0989 for more information.

Ensuring Safety in Hospice Care: A Commitment to Excellence

Ensuring Safety in Hospice Care: A Commitment to ExcellenceThe importance of safety in the workplace for healthcare providers cannot be overstated. As we approach OSHAs Safe and Sound Week in August, it is an opportune moment to highlight the critical measures we undertake to ensure a safe work environment for our staff and patients. This communication aims to inform our referral sources about our safety protocols and provide valuable tips that medical professionals may find beneficial for maintaining safety in their workplaces.Our Commitment to SafetyIn hospice care, where the environment can be unpredictable and emotionally charged, maintaining rigorous safety standards is paramount. Our commitment to safety is evidenced by our comprehensive safety programs, continuous staff training, and adherence to OSHA guidelines. According to the Bureau of Labor Statistics (2023), healthcare workers face a higher rate of workplace injuries than workers in most other sectors, with nearly 5.5 injuries per 100 full-time workers annually. This statistic underscores the importance of our ongoing efforts to mitigate risks and promote a culture of safety.Staff Training and EducationOngoing Training: All our staff undergo regular training sessions that cover the latest safety protocols, emergency procedures, and the proper use of personal protective equipment (PPE). Research has shown that continuous education significantly reduces the incidence of workplace injuries (Smith et al., 2022).Ergonomic InterventionsProper Lifting Techniques: Back injuries are a common concern in healthcare settings. We emphasize training on proper lifting techniques and the use of mechanical lifts when necessary to prevent musculoskeletal injuries (Anderson et al., 2020).Infection Control MeasuresStrict Hygiene Protocols: Adherence to stringent hygiene protocols, including regular handwashing, use of sanitizers, and appropriate use of PPE, is mandatory. These measures are crucial in preventing the spread of infections among staff and patients (CDC, 2022).Mental Health SupportCounseling Services: Recognizing the emotional toll that hospice work can take, we offer counseling services to support our staffs mental health. Studies have indicated that mental health support reduces burnout and improves job satisfaction among healthcare workers (Jones et al., 2021).Safety Tips for Medical ProfessionalsWhile our safety protocols are robust, there are additional tips that medical professionals may find useful in enhancing their safety at work:Use Technology WiselyTelehealth Services: Where appropriate, leverage telehealth services to reduce the need for physical interactions, thereby minimizing exposure to infectious diseases.Stay InformedContinuing Education: Keep abreast of the latest safety guidelines and best practices through continuing education programs. This knowledge is vital for adapting to new challenges and improving workplace safety.Promote a Safety CultureOpen Communication: Foster an environment where staff feel comfortable reporting safety concerns without fear of retribution. An open communication culture is essential for identifying and addressing potential hazards promptly (Davis et al., 2019).Personal Protective Equipment (PPE)Proper Use and Disposal: Ensure the correct use and disposal of PPE. Improper handling can negate the benefits and increase the risk of contamination.Safety in the workplace is a fundamental aspect of providing high-quality hospice care. By implementing rigorous safety measures and continuously educating our staff, we strive to create a secure environment for both our employees and patients. We encourage our referral sources to adopt similar practices to enhance safety within their own organizations. Together, we can build a safer healthcare system for everyone.  Call us today to learn more!ReferencesAnderson, J., Williams, M., & Smith, T. (2020). Ergonomic interventions in healthcare: A review of the evidence. Journal of Occupational Health, 62(4), 311-319. https://doi.org/10.1002/joh.22023Centers for Disease Control and Prevention (CDC). (2022). Infection control in healthcare settings. Retrieved from https://www.cdc.gov/infectioncontrol/index.htmlDavis, K., Turner, M., & Wrenn, G. (2019). Promoting a culture of safety in healthcare. Healthcare Management Review, 44(2), 123-135. https://doi.org/10.1097/HMR.0000000000000199Jones, A., Phillips, R., & Brown, L. (2021). Mental health support for healthcare workers: A systematic review. Journal of Occupational and Environmental Medicine, 63(1), 54-62. https://doi.org/10.1097/JOM.0000000000002025Smith, R., Johnson, P., & Martinez, S. (2022). The impact of continuous education on workplace safety in healthcare. American Journal of Industrial Medicine, 65(3), 233-245. https://doi.org/10.1002/ajim.23394U.S. Bureau of Labor Statistics. (2023). Occupational injuries and illnesses among healthcare workers. Retrieved from https://www.bls.gov/iif/

Why Catholic Hospice Matters

An interview with Dick McCormick, former CEO of US West and founding contributor to Emmaus Catholic Hospice.My brother, Fr. Jim, died in 2013. He was a Catholic priest for 51 years. He was battling cancer and came to Denver to live with us. That way, family could surround him, and we could give him personal support. He had excellent care, and for a while, we thought maybe he was on the verge of beating it. But then he took a turn for the worse.LAY MINISTER PRAYING OVER A PRIESTWe had priests come by the house in the last month of his life and give him Last Rites, including Archbishop Aquila of Denver and Bishop Hannifen from Colorado Springs. So, he had plenty of people visit him and pray with him!In the last week or so, we called in hospice services. The irony is that when he did die, a lay minister from the hospice came. It was appropriate, but it was ironic, too: Here was a priest of 51 years who had given his life to the Churchand an unordained layperson was praying over him a few hours after he died.And I just thought, It would have been nice if he had been surrounded by a hospice team rooted in the Catholic faith, taking care of him and taking care of those final needs.We thanked the hospice people profusely, but it was a fairly impersonal experience.I believe that had we been with Emmaus Catholic Hospice, if it had existed then, there would have been a greater quality and a more personal quality of care.THE UPSIDE OF A MISCONCEPTIONA misconception I had when I first heard the word hospice in the mid-eighties, and for many years, was I thought it was more of a 24/7, hands-on service.We were left with the medications, and they instructed us how to administer them. But there wasnt necessarily going to be a staff of nurses there every moment. Maybe everybody knows that, but I didnt realize it.They told us that their objective was to make Jim pain-free. They showed us how to do that, and they didnt need to be there 24/7.It was nice not to have outsiders always there, just Jim and his family and close friends.A BEAUTIFUL DEATH IN ALL RESPECTSTo their credit, the hospice staff were able to predict within a day or so when Jim was going to pass away. They knew the vital signs, the blood pressure, the breathing changes, the colorall the indicators. They called it very well, and they had us well prepared for the time.Our daughter Meg sat with him all night that last night because we knew that was probably going to be it. He passed away in our living room, surrounded by family.It was a beautiful death in all respects and one that I felt was appropriate for the life that he lived and the contributions he made. More than 20 of his 51 years as a priest were spent doing missionary work in Tanzania, India, and the Philippines.Jim had a beautiful funeral back in our hometown in Iowa. He had recruited 25 African and Indian nuns to work in Catholic nursing homes in Iowa.  Also, through Jims efforts, three priests from India are now pastors in Northwest Iowa.  All of them were at his funeral. We had African singing; we had Indian singing; we had the church choir singing. I mean, he went out in style!SUPPORTING EMMAUS CATHOLIC HOSPICEMy wife, Mary Pat, and I support Emmaus Catholic Hospice because it aligns with the values and tenets of the Catholic church. Thats important to us.We are strong Right to Life people and very much against assisted suicide. I will not be associated with any organization that condones or conducts that.Mary Pat and I will probably need this service ourselves in the next ten years. So, were interested from that standpoint, too.Im hoping that Emmaus Catholic Hospice gets off the ground in a big waythat it becomes the source for anybody Catholic who needs hospice services.We must communicate to the Catholic community that this is now available and needs our support.as told to Katie Morroni, Communications Manager of Emmaus Catholic Hospice. Interview edited for length and clarity. To learn more and support the mission of Emmaus Catholic Hospice, please visit EmmausCatholicHospice.org

Local Services By This Author

Abode Home Health

Home Health 1038 Eagleridge Boulevard, Pueblo, Colorado, 81008

At Abode Home Health, we understand that each patient has unique needs. We also understand there is no one-size-fits-all solution when it comes to healthcare. Home Health is a great option for those who need extra assistance, but do not need to be in a hospital or other care facility. Our services can help patients avoid unnecessary hospitalizations, speed up recovery time, and allow them to stay in their own homes where they can feel safe and secure.