Palliative Care vs. Hospice Care


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Our goal 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.

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  • 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
  • Explain
  • Palliative Care vs. Hospice Care

    1. 1. 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
    2. 2. 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 hospice patients.
    3. 3. 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 to accomplish.
    4. 4. 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.
    5. 5. 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 calls “home.”
    6. 6. 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 other’s expense • More goal centered • Interdisciplinary team of caregivers, participating in holistic care of patient and family
    7. 7. Why Hospice Care? • Provides physical, emotional and spiritual support 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
    8. 8. 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 management • May not have a terminal prognosis
    9. 9. 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, and… • …is no longer seeking aggressive treatment
    10. 10. 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 additional certifications.
    11. 11. 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
    12. 12. 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 conditions, including: – Medications – Treatments – Catheter/wound supplies – Blood work – Procedures – Therapy – Hospitalization – Durable medical equipment (DME) – Ambulance transport, as needed
    13. 13. 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 time
    14. 14. Levels of Hospice Care, cont. • Respite – 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
    15. 15. Hospice Team Members • Core – 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 (as appropriate)
    16. 16. About VNA Hospice • Program started in 1980; one of the oldest in the area • Serves southwestern York County and all of Adams County • 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 most
    17. 17. 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 (uncompensated care)
    18. 18. THANK YOU