Hospice and Palliative Care

Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness that is approaching the end of life. It often includes emotional and spiritual support for both the patient and their loved ones.

What is Hospice Care?

Hospice care is a service for people with serious illnesses who choose not to get (or continue) treatment to cure or control their illness.

Hospice aims to provide comfort and peace to help improve the quality of life for the person nearing death.

It also helps family members cope with their loved one’s illness and can also provide support to the family after the person dies, including help with grieving, sometimes called bereavement care.

Medicare reimburses for hospice services if and when your physician determines that a patient has a life expectancy of 6 months or less.

Many people with serious illnesses use hospice care. A serious illness may be defined as a disease or condition with a high risk of death or one that negatively affects a person’s quality of life or ability to perform daily tasks.

Examples of serious illnesses include dementia, cancer, heart failure, and chronic obstructive lung disease.

Am I Eligible for Hospice Care?

Anyone with a serious illness who doctors think has a short time to live — generally 6 months or less —usually qualifies for hospice care.

For Medicare to pay for hospice care, patients must stop medical treatment intended to cure or control their illness.

When Should I Start Hospice Care?

Despite the benefits of using hospice care, many people wait to receive hospice care until the final weeks or days of life.

It’s important to talk with your doctor about your illness and how your disease is progressing.

What Services Does Hospice Care Provide?

Hospice care can provide a range of different services depending on your symptoms and end-of-life care wishes.

These services include but are not limited to, emotional and spiritual support for the person and their family, relief of symptoms and pain, help with advance care planning, therapy services, like physical or occupational therapy, and much more.

Where Does Hospice Take Place?

Hospice can be provided in many settings — a private home, nursing home, assisted living facility, or in a hospital.

Should I Include Hospice Care in My Advanced Care Planning?

Yes! Advance care planning involves making decisions ahead of time about the health care you would want to receive at the end of life.

Do I Have to Stop Other Medication If I’m in Hospice?

When you begin hospice care, medication and other treatments to cure or control your serious illness will stop.

For example, if you are receiving chemotherapy that is meant to treat or cure your cancer, that must end before you can enter hospice care.

However, a person in hospice can continue to take medications to treat other conditions or symptoms, for example, high blood pressure.

Will My Insurance Cover Hospice Care?

Most Medicaid, Medicare, and private insurance providers will cover some of the services provided by hospice.

Older adults enrolled in Medicare can receive hospice care if their healthcare provider thinks they have 6 months or less to live.

Does Hospice Include 24/7 Care?

While some may think hospice provides 24-hour a-day, 7 days a week custodial care, or full-time care at home or an outside facility, this is rarely the case.

Although hospice provides a lot of support, most of the day-to-day care of a person dying is provided by family and friends.

However, a person from a hospice care team is usually always available by phone 24/7.

How Does Hospice Benefit People with Advanced Dementia?

Most people with advanced dementia cannot communicate clearly, which means they may not be able to share their concerns with their caregivers.

Hospice whether used at home or in a medical facility can provide caregivers and the person with dementia the support they may need near the end of life.

What Are the Benefits of Using Hospice Care?

Studies have shown that when a person enrolls in hospice care they are more likely to have increased family satisfaction and better symptom and pain management.

They are also less likely to undergo tests or be given medication they don’t need or want.

Palliative Care

What is Palliative Care?

Palliative care is specialized medical care for people living with a serious illness.

Palliative care can be received at the same time as your treatment for your disease or condition.

It focuses on providing relief from the symptoms and stress of serious illness.

The palliative care team works to prevent or ease suffering, improve the quality of life for both the patient and their family, and help patients and their families make difficult healthcare decisions.

A serious illness may be defined as a disease or condition with a high risk of death or one that negatively affects a person’s quality of life or ability to perform daily tasks.

It may cause symptoms or have treatments that affect daily life and lead to caregiver stress.

Examples of serious illnesses include dementia, cancer, heart failure, and chronic obstructive lung disease.

Who Provides Palliative Care?

A palliative care team may include specialist nurses and doctors, social workers, religious or spiritual leaders, therapists, or nutritionists, among other professionals.

Your team may vary depending on your needs and level of care.

How Does Palliative Care Differ from The Care I’m Getting Now?

Palliative care can be provided alongside of your current treatment and care. Your palliative care team works with your current doctor and others to provide specific treatments and care plans.

Palliative care is meant to enhance your current care by focusing on the quality of life for you and your family.

How Do I Know If I Need Palliative Care?

People living with a serious illness such as cancer, heart disease, lung disease, or kidney failure, may experience emotional or physical pain related to their illness.

If you’re having trouble coping with this pain, palliative care may be right for you.

You don’t need to wait until your disease is in the advanced stages or you’re in the final months of life to start palliative care.

Where Can I Find Palliative Care?

Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics certain other specialized clinics, or at home.

Will My Insurance Cover Palliative Care?

Most private insurance plans at least partially cover palliative care services. Medicare and Medicaid also typically cover most of these services.

Does Using Palliative Care Mean I’m Dying?

Not necessarily. Palliative care is meant to relieve symptoms such as pain, breathing difficulties, or nausea, among others, and relieve stress for patients and their families.

Palliative care can be used at any time after diagnosis of a serious illness.

How Does Hospice Care Differ from Palliative Care?

Hospice care is a specialized form of palliative care that is delivered in the final months or weeks of life.

Hospice care is used when patients and their families no longer wish to pursue treatments that are meant to slow or halt the progression of an illness, and instead focus only on comfort care.

Should I Include Palliative Care in My Advanced Care Planning?

Advance care planning involves making decisions ahead of time about the health care you would want to receive at the end of life or in a medical crisis.

When a person is diagnosed with a serious illness, they should prioritize early advanced care planning conversations with their family and doctors. support, and increased patient and family satisfaction.

Different Care Settings at the End of Life

The three most common places people at the end-of-life die are at home, in a hospital, or a care facility.

While not everyone has the chance to decide where they will die, people who know the end of life is approaching may be able to plan.

End-of-life care at home

Home is likely the most private setting for someone who needs end-of-life care. It allows for family and friends to come and go freely and may give the person who is dying a sense of comfort.

Services such as visiting nurses as well as special equipment, such as a hospital bed or bedside commode, can be arranged to be at the home.

A caregiver or family member needs to work closely with the health care team to decide the type of comfort care needed at home to make the dying person as comfortable as possible. 

End-of-life care in hospitals

In a hospital setting, you will have access to medical professionals who understand the needs of a dying person. This can be very reassuring to both the person and their family.

In addition to the regular care team, some hospitals have palliative and hospice care teams that can assist with managing uncomfortable symptoms at the end of life, such as digestive issues or pain.

These teams can also help with making medical decisions for patients or families.

If you are receiving hospice care, the hospice team can assist the care facility staff with end-of-life care.