What Is Hospice Care?
Although palliative care and hospice focus on the quality of life by reducing pain and providing support, there are significant differences between the two. Hospice is specifically for those with an advanced illness and who have chosen not to continue curative treatment. In contrast, palliative care can be provided at any time and works in conjunction with other medical treatments.
What Is It?
Hospice is specialized medical services, usually provided in the home. Like palliative care, hospice provides comprehensive comfort care and support for the family; however, it is only intended for those whose doctor anticipates a life expectancy of 6 months or less. A doctor oversees hospice, and services are provided by a team of nurses, social workers, aides, therapists, and spiritual counselors - with the hospice team becoming the primary medical provider. During hospice, there are no further attempts to treat the illness. However, medications that enhance the quality of life, such as for high blood pressure or anxiety, can be provided. Hospice is often selected when the burdens of treatment outweigh the benefits.
Hospice services include:
Pain and symptom management, including nurse home visits
Medications and medical supplies, including hospital beds
Emotional and grief support
Education and training for caregivers
Speech and physical therapy services, if needed to manage symptoms or pain
Limited hospice aide services for personal care
24 hour/7 day a week availability to respond to patient and caregiver concerns
Short-term inpatient care when pain or symptoms become too difficult to manage at home or when caregivers need respite time
Bereavement support services
Hospice does not provide the day-to-day care that most hospice patients require. Although the hospice team makes frequent visits and is available 24/7, a family or paid caregiver offers most of the daily care.
Who Can Receive It?
Hospice is intended for people with a terminal illness whose doctor anticipates a life expectancy of six months or less; however, patients can be recertified after six months and will continue to receive services as long as they meet hospice criteria. Additionally, patients may be disenrolled from hospice if their condition stabilizes and re-enroll at a later time if their health begins to decline again. To be initiated, a doctor must provide a medical order for hospice services.
Who Provides It and Where?
Hospice is provided by a hospice agency whose team includes nurses, a hospice physician, social workers, a spiritual counselor, hospice aides, and trained volunteers. The hospice team may also include the patient’s primary physician. Most hospice care is provided at home, with a family member typically serving as the primary caregiver. However, hospice care may also be available at hospitals, nursing homes, assisted living facilities, and dedicated hospice facilities in the community. The referring physician will likely have hospice recommendations, but patients and families can choose their hospice and change providers. Find a Medicare hospice provider.
What Is the Cost?
Medicare, Medicaid, and the VA cover Hospice care. In addition to covering the costs of medical care, Medicare and Medicaid will pay for related supplies, equipment, and medications.