FAQ

Palliative and Hospice Care FAQs

1.) What is Palliative care?
2.) What is hospice Care?
3.) What is the difference between Palliative and Hospice care?
4.) How do I know if palliative care is right for me?
5.) Is palliative care covered by insurance?
6.) Is hospice care covered by insurance?
7.) Do I have to change my PCP or my current healthcare team in order to get palliative care?
8.) Where do I go to get palliative care?
9.) Where do I go to get hospice care?
10.) When should I get palliative care?
11.) When should I start hospice care?
12.) Is hospice care 24/7

1.) What is Palliative care?
Palliative care is a specialized medical care approach focused on providing relief from the symptoms and stress of a serious illness. The primary goal of palliative care is to improve the quality of life for both the patient and their family by addressing physical, emotional, and spiritual needs. It is not limited to end-of-life care and can be integrated into the overall treatment plan for individuals with serious illnesses such as cancer, heart failure, chronic obstructive pulmonary disease (COPD), and more. Palliative care teams work collaboratively with other healthcare providers to determine goals of care, manage pain, symptoms, and the psychosocial challenges associated with the illness, aiming to enhance comfort and support overall well-being. There is no age limitation on receiving palliative care.

2.) What is hospice Care?
Hospice care is a specialized form of healthcare that focuses on providing compassionate and supportive services to individuals who are nearing the end of life. The primary goal of hospice care is to enhance the quality of life for patients with terminal illnesses by managing pain and symptoms, addressing emotional and spiritual needs, and offering practical support to both patients and their families. Hospice care is typically provided in the patient’s home, although it can also be administered in hospice facilities, nursing homes, or hospitals. This type of care emphasizes comfort, dignity, and respect during the end-of-life journey, and it often involves a multidisciplinary team of healthcare professionals, including doctors, nurses, social workers, chaplains, and volunteers. Medicare reimburses for hospice services when a physician determines that a patient has a life-expectancy of 6 months or less. Medicaid and most private insurance plans, HMOs, and other managed care organizations also support Hospice care.

3.) What is the difference between Palliative and Hospice care?
While both palliative care and hospice care are specialized approaches aimed at improving the quality of life for individuals facing serious illnesses, there are key differences between the two:
a.) Timing and Goals:
Palliative Care: It can be provided at any stage of a serious illness, not just in the advanced or terminal phases. The focus is on providing relief from symptoms and stress, improving the quality of life, and assisting with decision-making related to medical treatment. Palliative care can be received at any age.
Hospice Care: Typically, hospice care is initiated when a patient is nearing the end of life, and curative treatments are no longer effective or desired. The primary goal is to provide comfort and support in the final months of life.

b.) Treatment Focus:
Palliative Care: It can be provided alongside curative treatments. The emphasis is on managing symptoms, addressing emotional and spiritual needs, and supporting the patient and their family through the challenges of the illness.
Hospice Care: It is focused on comfort care and symptom management. Aggressive, curative treatments are usually discontinued, and the focus shifts to enhancing the patient’s quality of life in their remaining time.

c.) Location of Care:
Palliative Care: It can be delivered in various settings, including hospitals, outpatient clinics, and even at home.
Hospice Care: It is often provided in the patient’s home, but it can also be administered in specialized hospice facilities, nursing homes, or inpatient hospice units.

d.) Prognosis:
Palliative Care: Patients may receive palliative care regardless of their life expectancy, and they can continue receiving it while undergoing curative treatments.
Hospice Care: Patients are typically eligible for hospice when they have a prognosis of six months or less if the illness follows its normal course. However, hospice care can be extended beyond six months if the patient’s condition remains terminal.

e.) Insurance
Palliative Care: Not covered by all insurance plans
Hospice Care: Usually covered by most insurances and Medicare
Understanding these differences helps healthcare professionals and families make informed decisions about the appropriate type of care for individuals facing serious illnesses.

4.) How do I know if palliative care is right for me?
Choosing palliative care is a personal decision. It is appropriate for individuals facing serious illnesses such as cancer, heart failure, chronic obstructive pulmonary disease (COPD), dementia, and others. It can be beneficial when you are facing complex treatment decisions and need assistance in understanding your options. Palliative care takes a holistic approach. If you desire comprehensive care that considers your overall quality of life, palliative care may be suitable. It is not limited to end-of-life care and can be integrated at any stage of a serious illness.

You should discuss your preferences and goals of care with your healthcare team. They can provide information, answer your questions, and collaborate with you to tailor a care plan that aligns with your values and priorities.

Here are some considerations and indicators that may suggest palliative care could be beneficial:
a.) Serious Illness or injury
b.) Multiple Symptoms or Discomfort
c.) Frequent Hospitalizations or ER visits
d.) Complex Treatment Decisions
e.) Emotional and Spiritual Support Needs
f.) Need for Holistic Care

5.) Is palliative care covered by insurance?
Insurance typically covers palliative care services, although coverage may vary depending on the specific insurance plan and provider. They may cover all or part of the treatment. Many private health insurance plans, as well as government programs such as Medicare and Medicaid, offer coverage for palliative care services.

It’s important to review your insurance policy or contact your insurance provider directly to understand the extent of coverage for palliative care services. Additionally, healthcare providers offering palliative care can assist in navigating insurance coverage and billing processes to ensure that patients receive the necessary care without financial burden. You can talk to a social worker about payment options.

6.) Is hospice care covered by insurance?
Most health insurance plans, including Medicare, Medicaid, and many private insurance policies, provide coverage for some of the hospice care services. Medicare Part A, for instance, covers hospice care for beneficiaries who meet eligibility criteria, including having a terminal illness with a life expectancy of six months or less if the illness runs its natural course. They might have to sign a form as per Medicare guidelines.

It’s essential to review your insurance policy or contact your insurance provider directly to understand the specific hospice benefits covered under your plan. Additionally, hospice programs often have financial counselors who can help navigate insurance coverage and address any concerns related to payment for hospice care services.

7.) Do I have to change my PCP or my current healthcare team in order to get palliative care?
No, you do not have to give up your primary doctor or healthcare provider when receiving palliative care treatment. The palliative care team works alongside your existing medical team, including your primary care physician (PCP) or specialist doctors. Your primary doctor remains an essential part of your care team, collaborating with palliative care specialists to ensure comprehensive and coordinated care.

8.) Where do I go to get palliative care?
Palliative care services are available through various healthcare settings like hospitals, outpatient clinics, home care agencies, long-term care facilities and others. Basically it is available in places close to where you live. hospice programs also provide comprehensive palliative care services to patients who are nearing the end of life. Hospice care is typically provided in the patient’s home, although it can also be administered in hospice facilities, nursing homes, or hospitals.

To access palliative care services, you can speak with your primary care physician or healthcare provider to discuss your needs and preferences. They can help you find local palliative care resources and make arrangements for you to receive the appropriate care based on your individual circumstances and goals. Additionally, you can contact hospice programs or palliative care providers directly to inquire about available services in your area.

9.) Where do I go to get hospice care?
Palliative care services are available through various healthcare settings like hospitals, outpatient clinics, home care agencies, long-term care facilities and others. Basically it is available in places close to where you live. In addition hospice programs provide comprehensive palliative care services to patients who are nearing the end of life. Hospice care is typically provided in the patient’s home, although it can also be administered in hospice facilities, nursing homes, or hospitals.

To access palliative care services, you can speak with your primary care physician or healthcare provider. They can help you find local palliative care resources. Additionally, you can contact hospice programs or palliative care providers directly to inquire about available services in your area.

10.) When should I get palliative care?
It’s important to consider palliative care when you or a loved one are facing a serious illness, regardless of the stage of the illness.

It’s important to remember that palliative care is not limited to end-of-life care and can be provided at any stage of a serious illness. By initiating palliative care early in the illness trajectory, you can benefit from comprehensive support, symptom management, and improved quality of life throughout your healthcare journey. Don’t hesitate to discuss your palliative care needs with your healthcare provider or ask for a referral to a palliative care specialist when appropriate.

11.) When should I start hospice care?
Deciding when to start hospice care is a deeply personal and often complex decision. Here are some indicators that may suggest it’s time to consider hospice care:
a.) Prognosis of Six Months or Less
b.) Decline in Health Status
c.) Unmanageable Symptoms
d.) Desire to Focus on Comfort
e.) Goals of Care Alignment

Hospice care can be initiated when the patient and their healthcare team agree that the focus should shift from curative treatment to comfort care and support during the end-of-life journey. Hospice teams can provide guidance, support, and resources to help you make informed decisions about your care or the care of your loved one.

12.) Is hospice care 24/7
Hospice care typically does not include 24/7 continuous care in the home setting. However, hospice programs do provide access to a hospice nurse or other healthcare professionals who are available to respond to patient and family needs on a 24-hour basis, typically through an on-call service. This means that if there are urgent concerns or needs outside of regular business hours, patients and families can contact the hospice program for assistance, guidance, or visits from hospice staff as needed.

References:
1.) Get Palliative Care is an independent website dedicated to providing clear, comprehensive palliative care information for people living with a serious illness
https://getpalliativecare.org/

2.) National Institute on Aging
https://www.nia.nih.gov/health/hospice-and-palliative-care/frequently-asked-questions-about-hospice-care

3.) National Hospice and Palliative Care Organization
https://www.nhpco.org/hospice-care-overview/hospice-faqs/

4.) Mount Sinai
https://www.mountsinai.org/care/palliative-care/faqs

Note: Please note that AIMS MedCare is not affiliated with any of the above organizations or institutions.