When someone is facing a serious illness, overcoming the myths and misconceptions about hospice services is a big first step. When first hearing the words hospice or palliative care, most people have a visceral reaction — fear. The terms hospice and palliative care are often used interchangeably, even though they have different meanings. Understanding the differences between palliative care and hospice care helps organizations start a quality discussion with the patient and family as the first step in dispersing the fear.
The goals of both hospice and palliative care are for the patient and family to have an increase in comfort, emotional support, help with important medical decisions and an improved quality of life. The detailed difference between the two services is how and when.
Palliative Care vs. Hospice Care
The MedlinePlus Medical Encyclopedia describes the difference between palliative and hospice care by saying, “Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear the person is not going to survive the illness.”
Palliative care and hospice care both provide comfort, reduce stress, offer complex symptom relief related to a serious illness and help with psychosocial issues. However, there are significant differences aside from what they provide in common.
- When to start care: Palliative care ideally begins at the diagnosis of a life-threatening disease to help match the patient’s treatments to their goals of care. There is a focus on symptom management, education about the trajectory of the disease, goals of care discussions and completion of advance directives.
- Services included: Services received while on palliative care are based on the program the patient is enrolled in and may include visits from a social worker, nurse practitioner, registered nurse or physician assistant.
- Where care is provided: Most palliative care services are provided in the hospital, but home-based palliative care programs are becoming more widely available.
- Payment for care: Palliative care may be covered by insurance or paid for by the patient.
- Benefit periods: There is not a specific length of time designated that a patient receives palliative care services.
- When to start care: Hospice care is available when the patient has a prognosis of six months or less if the disease follows its normal course and the patient elects to stop curative care for the primary terminal diagnosis.
- Services included: A hospice patient receives visits from the registered nurse, social worker, chaplain and hospice aide. Durable medical equipment and some medications are also included.
- Where care is provided: Hospice is typically provided in the patient’s home. Inpatient care may be available on a short-term basis for acute symptom management or caregiver respite.
- Payment for care: Hospice care is covered by Medicare Part A through the Medicare Hospice Benefit. Hospice may also be covered by private insurance and Medicaid.
- Benefit periods: Hospice care is delivered in benefit periods; the first two benefit periods are 90 days long and are followed by an unlimited number of 60-day benefit periods for as long as the patient continues to qualify for hospice care.
It is important for organizations to watch palliative care patients for hospice eligibility so they can access their Medicare Hospice Benefit as soon as possible. Families of hospice patients who have had services for 60 days or more experience better outcomes and less complicated grief.
It is helpful to use software that includes hospice and palliative care documentation within the solution. Select an intuitive platform that will enable your team to run reports on advance directives, hospitalized patients and diagnoses.