1. Hospice and Palliative Care: Is there a Difference? Carl Wills HCM387-0904A-01 Phase 3 Task 3 Individual Project Professor Jacquelyn Edenfield Colorado Technical University Online November 3, 2009
2. Hospice and Palliative Care Delivery of care Caring Quality of Life Comfort Care 2 Hospice and Palliative Care: Is there a difference?
3. Hospice and Palliative Care Philosophies Identical: Team-oriented approach to care Quality of life Pain and symptom control Patient and family support Interdisciplinary care Complementary service. Hospice care: For dying patients and their families (6 months or less) Palliative care: Focus on delivery of care Fills in the gaps for serious ill patients and families who do not qualify for hospice care. Is available regardless of diagnosis and/or prognosis. 3 Hospice and Palliative Care: Is there a difference?
4. Hospice Care Comfort Care For terminally ill individuals. Focus on Caring When curing is no longer an option. Team-oriented approach to medical care: Pain and symptom management, emotional and spiritual support, and patient specific care. Individual has six months or less to live. Covered under: Medicare Hospice benefit, Medicaid, most private insurance plans, HMOs, and other managed care programs. 4 Hospice and Palliative Care: Is there a difference?
5. Palliative Care Not dependent on prognosis. Customized treatment. Care can be provided in conjunction with treatment (i.e., chemotherapy). Team-oriented approach to care: Physicians, nurses, social workers, religious entities, and other specialty care providers. Emotional and spiritual support for patients and their families. Covered by: Health insurance plans, Medicare and Medicaid (not under hospice benefit and must be billed individually). 5 Hospice and Palliative Care: Is there a difference?
6. Hospice and Palliative Care Similarities and Differences Hospice and Palliative Care: Is there a difference? 6 Similarities Compassionate care Team-oriented Pain and Symptom Management Patient and family support (i.e., emotional, spiritual, etc.) Share a common core belief Differences Hospice care: Caring when curing is not the option. Life expectancy six months or less. Covered benefit under Medicare. Palliative care: Offered regardless of diagnosis and/or prognosis. Is not restricted because of time. Is not a covered benefit under Medicare unless services billed separately.
7. References Palliative Care Program and Services. (2004). Palliative care program. Retrieved November 1, 2009, from http://www.froedtert.com/Specialtyareas/PalliativeCareProgram/Prog... Palliative Care Quick Facts. (2009). Palliative care: What you need to know. Retrieved October 25, 2009, from http://www.getpalliativecare.org/quick-facts/ Wuerl, A. (n.d.). Hospice and palliative care: Where’s the common ground? Retrieved November 1, 2009, from http://www.gilbertguide.com/articles/hospice-palliative-care-wheres-t... The presentation is now open for questions and/or comments. 7 Hospice and Palliative Care: Is there a difference?
Editor's Notes
Welcome Non-Clinical Managers to today’s presentation on hospice and palliative care and the difference between the two. As you may or may not know, the vice president of patient care is very interested in developing and implementing a palliative care program at G.I. Jones Memorial hospital. With that being said, the purpose of this presentation is to explain what hospice and palliative care is and their similarities and differences with the goal of eliminating any confusion between the two programs. When an individual has been told that their diagnosis (illness and/or disease) is life-limiting, grief stages generally will overwhelmed the individual and their families. Unfortunately, hospice and palliative care are often used interchangeably creating confusing between the two types of care. Let’s begin by understanding their philosophies and then clarify what hospice and palliative care is as an available option of care.
Hospice and palliative care are designed to actively care for people with life-threatening diseases and although their philosophies of care are basically identical (focus on quality of care, pain and symptom management, patient and family emotional and spiritual support) there are specific differences between the two (Palliative Care Quick Facts, 2009). Hospice care is caring when curing is no longer and option. Eligibility for hospice care requires two physicians (primary physician and hospice physician) to certify that the individual’s prognosis of living is six months or less. Furthermore, the hospice philosophy embraces death as a natural part of life. Palliative care although similar, naturally follows curative treatments such as chemotherapy, radiation, blood transfusions, dialysis, physical therapy, and many others while trying to control or eradicate the disease and/or illness process. Furthermore, palliative care has no time limits regardless of diagnosis and/or prognosis. Essentially, palliative care is an extension of the hospice philosophy of managing acute (current onset) care in a long-term care setting.
Generally, when treatment options fail or have been exhausted, a physician may suggest hospice care. Hospice care can be provided at one’s home, nursing homes, residential care facilities, and hospice facilities where the goal is centered on quality of life by managing pain and symptoms and providing individual and family support based on the individuals specific care needs (Wuerl, n.d.). Furthermore, hospice care is covered by Medicare, Medicaid, most private insurance plans where charges are based on the individuals terminal diagnosis.
Palliative care is the ongoing activity of caring for people with life-threatening illnesses and/or diseases. While palliative care is similar to hospice care, the main focus is maximizing quality of life by assisting patients in their daily lives with the support of their families (Palliative Care Programs and Services, 2004). Palliative care can be provided regardless of diagnosis and/or prognosis, care is customized to the patients individual needs, goals, and outcomes, and like hospice care, is team oriented. Palliative care involves pain and symptom management, communication and coordination, and emotional and family support. Furthermore, palliative care can be provided in conjunction with hospice care. Individuals not applicable for hospice care who receive palliative care can be assured that most health insurance plans and government sponsored health benefits will cover care. However, Medicare and Medicaid will cover services as long as the services are billed separately.
Although, hospice and palliative care both provide compassionate care for individuals (patients) facing life-threatening illnesses and/or diseases, they both share ideological team-oriented approach to care (i.e., pain and symptom management, patient and family support, communication, and coordination). Furthermore, both types of care share a common core belief that every patient deserves the best possible care, patients have the right to die with dignity and respect, and pain-free (Wuerl, n.d.). However, to minimize confusion, hospice care is provided when all treatment has been exhausted and two physicians (primary provider and hospice provider) certify that the individual (patient) has six months or less to live. While on the other hand, palliative care is not limited to time or dependent on diagnosis/prognosis, and can be provided in conjunction with treatment. To minimize confusion, remember hospice care is time limited and palliative care as no time restrictions. Furthermore, it’s important to keep in mind that when an individual is receiving hospice care, the patient is essentially receiving palliative care. The only difference between the two is time and financial differences (i.e., Medicare hospice benefit and six months or less to live).
In closing, I trust this presentation on hospice and palliative care provided you with a generic understanding of both types of care with an emphasis of explaining how they are similar and significantly different. If anything, palliative care is not the same as hospice care even though they both provide compassionate care. Palliative care can be provided at any time regardless of diagnosis and/or prognosis. Palliative care can also be provided in conjunction with receiving treatment. On the other hand, individuals receiving hospice care are essentially receiving palliative care. The main difference between the two is when treatment has been exhausted and two physicians certify an individual is terminally ill with a life expectancy of six months or less, individuals (patients) will be provided hospice care.
