Hospice and Palliative Care

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Hospice is care for individuals who have life limiting illnesses. Generally, those with a life expectancy of six months or less can be admitted to a hospice. Hospice care is available through Medicare and many health insurance plans. Hospice care can be made available in a nursing home, one’s residence, at hospital hospice units and inpatient care centers.

Hospice teams create an individual plan outlining the level and frequency of care. The plan is modified as an individual’s condition changes. Hospices neither advance nor hinder the process of dying but direct their effort to providing comfort and lessening pain. They also serve an important role in working with family members, providing support and information on the process of dying. Hospice care varies among agencies, so if you reside in an area where there are several options to select from, take the time to compare the services offered by each agency.

Resources

Hospice Directory provides information on:

  1. choosing a hospice;
  2. eligibility;
  3. how payment of made through Medicare or Medicaid;
  4. how to become a hospice volunteer; and
  5. state hospice organizations.

This site has an excellent search option for finding a hospice in your area.

Hospicenet provides comprehensive information on hospices as well as dying and bereavement. Notable elements to this site include information on:

  1. Locating a hospice in your area.
  2. Questions you should ask when considering hospice care.
  3. Information for the terminally ill on the use of pain relievers.
  4. A description of the needs of dying patients.
  5. Questions you should ask if you are diagnosed as having a terminal illness.

Medicare and Hospice Benefits is a two page booklet published by the Centers for Medicare and Medicaid Services This booklet provides information on the following:

  1. What hospice services are covered by Medicare.
  2. The length of time medicare will pay for these services.
  3. The services that are not covered by Medicare
  4. When you can terminate services.
  5. Your rights when Medicare covers the cost of hospice services.

Visiting Nurses Association of America has a useful list of criteria to consider when selecting hospice care. These criteria address:

  1. Written policies you should request regarding malpractice, insurance, payment and employee job descriptions.
  2. Accreditation of the hospice facility or organization.
  3. References for staff and staffing levels of the agency.
  4. Process for planning individual care.
  5. Level of care and payment options.

Palliative Care

Palliative care provides relief from pain, discomfort, fatigue or other symptoms associated with a serious illness. Palliative care is not the same as hospice care although they both seek to provide an individual with the reduction of pain and the provision of a comfortable environment.  Unlike hospice care, there is no assumption that one receiving palliative care has a terminal illness and this type of care can be provided along with traditional treatments.

Palliative care is traditionally conducted within the context of a medical team consisting of a palliative doctor, social worker, nurses, and your primary doctor. Palliative care is generally not covered by Medicaid and Medicare.

Resources

Steps in obtaining palliative care, outlined by the Center to Advance Palliative Care, provides guidelines for discussing your interest in palliative care with your primary doctor and a drop down listing by state and city providing listings of medical facilities that provide palliative care.

The National Institute of Nursing Research provides a concise overview of palliative care, how to decide if you need palliative care, and when to start care.

Palliative Doctors, developed by the American Academy of Hospice and Palliative Medicine is a comprehensive site providing information the the following:

  1. What is palliative care?
  2. What do palliative doctors do?
  3. Benefits of palliative care.
  4. A palliative doctor locator.
  5. Descriptions of personal experiences of palliative care written by patients of various ages.

The Center to Advance Palliative Care provides a national ranking of palliative care by state. This site also provides links to informative resources on palliative care.

Get Palliative Care displays hospitals which provide palliative care. This easy to use site has a drop down menu to identify your state and corresponding cities and hospitals in your state where palliative care is available.

The National Institute of Aging provides information on finding care at the end of life. This resource discusses end of life care at home, in the hospital, nursing home,  palliative care and hospice. It also provides a list of relevant questions that should be asked in arriving at a decision for end of life care. This Web page also provides links to additional resources.

(photo: Martin Helgan)