Palliative Care and Hospice

Hospice Care

Palliative Care

A doctor certifies that if the disease progresses as anticipated, life expectancy is 6 months or less.

Hospice care may be appropriate for the patient, but the patient may choose skilled nursing services instead, or may not be philosophically ready for hospice.

The focus is on end-stages of terminal or life-limiting illness.

The patient may receive palliative care earlier in the course of illness, whether it’s terminal or life-limiting/chronic.

The focus is on comfort care only, relieving pain and other symptoms, not on cure. “Do Not Resuscitate” requests are generally preferred at this stage.

The focus is on comfort, but the patient can continue to pursue aggressive treatment.

Services can be provided at home, hospital, nursing home, assisted living or hospice center.

Most frequently, palliative care is give to nursing home residents.

Teams of nurses, nurse's aides, social workers and spiritual counselors are available for patient, and bereavement services can extend for more than a year after the patient’s death.

Typically, an Advanced Practice Nurse, or APN, is visiting the patient and addressing symptom management concerns. If symptoms are managed, the APN visits then stop. Bereavement services are available if needed.

Medicare, Medicaid and to some extent or for a limited time most private insurances would pay for hospice service.

Insurance plans, HMOs, Medicare and Medicaid pay for palliative care.

Education and communication with the patient and family about disease state, symptom management and the dying process remain important tasks.

Education and communication remain a high priority.