Discuss what “home” can mean – private residence, ALF, Personal Care home, nursing home, etc. Briefly explain difference between hospice residences and inpatient hospice houses.
2010 study in New England Journal of Medicine that lung cancer patients receiving palliative care survived 2.7 months longer than patients without palliative care interventions.
Give an example of caregiver breakdown
Thursday, February 13, 2014
Palliative Care vs. Hospice Care:
What’s the Difference?
Cross Keys Village – The Brethren Home Community
Visiting Nurse Association of Hanover and Spring Grove
Palliative Care vs. Hospice Care
• Our goal this morning is to cover the wide areas
of overlap and similarities between the two
disciplines, and to also make the differences
between the two clearer for you.
• VNA is one of the regular hospice providers at
Cross Keys Village, and in the greater community.
• A small wing of the Health Care Center at Cross
Keys Village is usually being used by palliative and
Palliative Care vs. Hospice Care
• The core of Palliative care and Hospice care are
the same: to provide comfort and pain/symptom
management and optimize quality of life.
• Hospice patients receive Palliative care, but not
every Palliative care patient will enter Hospice.
• The goals of Palliative care and Hospice care are
different, and depend on what the patient wants
What is Palliative Care?
• Palliative care improves the quality of life for
patients with serious illnesses by relieving
symptoms, pain and stress.
• Palliative care can happen at any point during
a patient's illness.
• Often accompanies other kinds of treatment.
What is Hospice Care?
• Hospice is a care program that provides
assistance to those individuals who have an
incurable disease and have chosen not to
pursue any further aggressive treatment.
• Hospice considers the patient and
family/caregivers as one unit of care –
provides support for all.
• Hospice care is provided wherever a patient
Why Palliative Care?
• Aggressive measures for control of pain and
other distressing symptoms
• Better quality and often longer life, with
neither quality or quantity achieved at the
• More goal centered
• Interdisciplinary team of
in holistic care of patient and family
Why Hospice Care?
• Provides physical, emotional and spiritual
to individuals at end of life
• Helps patients remain in their home
• Offers pain and symptom management
• Helps individuals live the best that they can
with what they have been given
• Focuses on quality of life more than quantity
Who is eligible for Palliative Care?
• Patients with life-limiting diseases who may
still be seeking curative treatment
• Sufferers of chronic conditions which require
aggressive pain management and symptom
• May not have a terminal prognosis
Who is eligible for Hospice Care?
• An individual who has a life expectancy of six
months or less if the terminal illness runs its
normal course, as determined by a physician,
• …is no longer seeking aggressive treatment
Palliative Care Payment
• Palliative care is paid like any other medical
care, via insurance or Medicare.
• The Palliative care physician is usually a
general practitioner or a geriatrician with
Hospice Care Payment
• Medicare and Medical Assistance
– Hospice care is paid per diem (paid a set amount
per day, varies from county to county)
• Private insurances
– Coverage varies, but most offer a hospice benefit
What Hospice Must Provide
• As part of per diem payment, hospice is responsible
for all items which are related to the palliation and
management of the terminal illness and related
– Medications – Treatments
– Catheter/wound supplies – Blood work
– Procedures – Therapy
– Durable medical equipment (DME)
– Ambulance transport, as needed
Levels of Hospice Care
• Routine Home Care
– Regular visits made by Hospice team members;
provided in the home setting
• Continuous Care (billed hourly)
– For patient symptom management only – cannot
be used for caregiver breakdown
– 51% of the service must be RN/LPN level
– Social work/counselor does not count towards the
Levels of Hospice Care, cont.
– For caregiver relief
– A five-day stay at a contracted facility
• General Inpatient
– Admission to a hospital or inpatient Hospice unit
for symptoms that cannot managed at home
– Short stay to get patient controlled and home
– An actively dying patient does not automatically
qualify for this level
Hospice Team Members
– Hospice Medical Director/Attending Physician
– Hospice Nurse
– Hospice Social Worker
– Hospice Spiritual Counselor/Bereavement Counselor
• Support Service
– Hospice Aide/Homemaker
– Patient Care Volunteer
– Physical, Occupational, or Speech Therapist
About VNA Hospice
• Program started in 1980; one of the oldest
in the area
• Serves southwestern York County and all of
• Non-profit, community-based
• Volunteer Board of Directors
• Will accept any patient, regardless of their ability
to pay or the severity of their medical need
• Staff live within the community they serve;
allows for faster response time when it matters
About CKV Health Care Center
• 270 beds, MedA and MA certified
• Serves Hanover, Gettysburg, York triangle
• Non-profit, faith-based
• Large charitable element to Mission