Caring for sick and elderly family members is a common occurrence that comes with many important decisions. Knowing what kind of care they need is valuable.
What is the difference between hospice and palliative care?
Hospice care and palliative care are very similar. In fact, they include many of the same services. With palliative care, you may still be seeking a cure or treatment for the illness whereas, with hospice, you are treating symptoms and looking to create a good quality of life.
Both hospice and palliative care involve a team of doctors and other professionals working together to achieve the best quality of life for the patient. Palliative care may begin as soon as you receive a diagnosis of a serious illness and may even transition into hospice. Hospice care is begun when the patient, along with their family and their doctor, has decided to no longer pursue treatment or a cure. In both cases, the goal is to provide care and help the patient be comfortable outside of a hospital setting.
What kinds of services are available?
For both palliative and comprehensive hospice care, there are many services and treatments available. Some of them may be:
- Nursing Services: having a nurse come to your home to help with routine care such as wound care or administering medicines.
- Home Health Aide: to help with personal duties such as bathing, changing bedding or helping with transportation. or moving from a bed to a wheelchair. A home health aide may help move the patient from a bed to a wheelchair or with meal preparation.
- Social Services: a hospice social worker focuses on pain management and emotional support for the patient and the family, including individual and group counseling therapy as well as bereavement counseling.
- Additional counseling services available may include spiritual or dietary counseling
- Medications: the medications prescribed will be focused on managing pain and other symptoms, depending on your insurance, they may all be provided.
- Medical equipment: some common medical equipment that may be provided includes oxygen equipment, c-pap machines, hospital beds, wheelchairs, crutches, blood pressure monitors and lifts.
- Occupational, Speech, or Physical Therapies: to help with speech, movement or learning to use adaptive techniques or equipment.
What will my insurance cover?
Insurance companies will differ in their plans, check with your provider to find out the details. Medicare has broken hospice care into four levels. Your level will be decided by your doctor. Different services and treatments are available under each level.
Level one is routine home care. For all hospice care, there is a primary caregiver, usually a family member, at home taking care of the patient most of the time. Services provided include:
- nursing or home health aide visits,
- social services,
- medical equipment,
- lab, and diagnostic studies
- some therapy services.
Level two is continuous home care. During continuous home care, the patient is still at home but is temporarily in need of more constant care. A nurse or aide will remain in the home for 8-24 hours each day. Some symptoms indicating the need for constant care may be unrelieved pain, severe nausea and vomiting, severe shortness of breath, and anxiety or panic attacks. The patient is evaluated every 24 hours to see if constant care is still needed.
Level three is general inpatient care. This is also temporary and used when symptoms are too severe to be treated at home. Facilities that provide these services include hospice facilities, inpatient hospice units within the hospital or a hospice unit in a nursing home. The patient will be evaluated often and returned home as soon as possible.
Level four is respite care. This is more for the family than for the patient. Respite care may be used when the patient doesn’t qualify for continuous or inpatient care, but the family needs more help. The patient is able to stay in an inpatient facility for up to five days at a time. This may be needed if the caregiver is under a lot of stress or for other extenuating circumstances.
How do I choose a hospice or palliative care provider?
There are many resources available to help you find a hospice or palliative care provider. Your local medical center or your insurance provider are good places to start. There are also many national organizations you can go to for more information. Organizations such as the National Hospice Foundation, the Hospice Foundation of America and the National Organization for Home Care and Hospice are just a few.
Be sure and get all the information you can before committing to a provider or program. Ask if they are accredited by a national organization, if they are licensed by the state, or Medicaid certified. Don’t be afraid to ask for professional references from a hospital or other professional. Have a list of the services on hand that your loved one needs and make sure they are all provided. Learn as much as you can about their admitting and payment procedures. Ask what kind of education and training their staff receive. Get as much information as possible on paper, so you can review it. Try to talk to current patients and their family members and take a tour of the facility if possible.
Is it time for hospice?
Although difficult, it is important to have that “end of life” discussion. Talk to your loved one, other family members, and your doctors. If your loved one wants to be comfortable at home, they shouldn’t spend their last days in a hospital getting unwanted treatments. Whether or not it is time for hospice is a personal decision. Consider what your loved one wants and needs and discuss with a doctor if hospice or palliative care is right for you.