The goal of this webinar was to educate healthcare professionals about the differences between palliative and curative care while exploring the history and philosophy of the hospice movement.

1. Palliative Care vs. Curative Care

2. CME Provider Information
Satisfactory Completion
Learners must complete an evaluation form to receive a certificate of completion. You must participate
in the entire activity as partial credit is not available. If you are seeking continuing education credit for
a specialty not listed below, it is your responsibility to contact your licensing/certification board to
determine course eligibility for your licensing/certification requirement.
Physicians
In support of improving patient care, this activity has been planned and implemented by Amedco LLC and
VITAS®
Healthcare. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical
Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses
Credentialing Center (ANCC), to provide continuing education for the healthcare team. Credit Designation
Statement – Amedco LLC designates this live activity for a maximum of 1 AMA PRA Category 1 CreditTM.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.

3. CE Provider Information
VITAS Healthcare programs are provided CE credits for their Nurses/Social Workers and Nursing Home Administrators through:
VITAS Healthcare Corporation of Florida, Inc./CE Broker Number: 50-2135. Approved By: Florida Board of Nursing/Florida
Board of Nursing Home Administrators/Florida Board of Clinical Social Workers, Marriage and Family Therapy & Mental
Health Counseling.
VITAS Healthcare programs in Illinois are provided CE credit for their Nursing Home Administrators and Respiratory Therapists
through: VITAS Healthcare Corporation of Illinois, Inc./8525 West 183 Street, Tinley Park, IL 60487/NHA CE Provider Number:
139000207/RT CE Provider Number: 195000028/Approved By the Illinois Division of Profession Regulation for: Licensed
Nursing Home Administrators and Illinois Respiratory Care Practitioner.
VITAS Healthcare, #1222, is approved to offer social work continuing education by the Association of Social Work Boards
(ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE
providers. State and provincial regulatory boards have the final authority to determine whether an individual course may
be accepted for continuing education credit. VITAS Healthcare maintains responsibility for this course. ACE provider
approval period: 06/06/2021 – 06/06/2024. Social workers completing this course receive 1.0 ethics continuing
education credits.
VITAS Healthcare Corporation of California, 310 Commerce, Suite 200, Irvine, CA 92602. Provider approved by the
California Board of Registered Nursing, Provider Number 10517, expiring 01/31/2025.
Exceptions to the above are as follows: AL: No NHAs, DE: No NHAs, DC: No NHAs, GA: No NHAs, KS: No NHAs, NJ:
No NHAs, OH: No NHAs, PA: No NHAs, TX: No NHAs, VA: No NHAs, WI: No NHAs and Nurses are not required –
RT only receive CE Credit in Illinois

4. Goal
• To appreciate the historical perspective
of curative and palliative care
• To comprehend the impact of palliative and
hospice care on patients and families,
the hospital, and the health system for
persons with advanced illness

5. Objectives
• Describe the history and
philosophy of the hospice and
palliative movement
• Identify the difference between
palliative and curative care
• Demonstrate the benefits
of palliative care for patients
with advanced illness
• Discuss the benefits that hospice and
palliative care can bring to hospital and
health systems
• Review how hospice as a medical
specialty fits under the palliative
care umbrella

6. How People Die
Emanuel, et al. (2003). The Education in Palliative and End of Life Care Curriculum
(EPEC Project). Northwestern School University Feinberg School of Medicine.
< 10% die suddenly of an unexpected event,
heart attack (MI), accident, etc.
> 90% die of a protracted, life-threatening illness
• Predictable steady decline with a relatively
short “advanced” phase (cancer)
• Slow decline punctuated by periodic crises
(advanced cardiac disease, advanced lung
disease, Alzheimer’s/dementia)

7. Dying Then and Now
19th Century:
• In 1900, 4% of America’s population
was > 65 years of age1
• In 1900, life expectancy was
49 years of age2
• Most people died at home
Today:
• Over 17% of the US population
is > 65 years3
• 2021 life expectancy in the US
was 76.1 years4
• Approximately 25% of Americans
die in acute-care hospitals and
25% die in nursing homes5
1
US Census Bureau (2011; US Census Briefs). The Older Population: 2010. Retrieved from https://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf
2US Centers for Disease Control. (2003). National Vital Statistics Reports, Volume 54/ Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_14.pdf
3US Census Bureau, Current Population Survey, Annual Social and Economic Supplement, 2022. Retreived from: https://www.census.gov/data/tables/2022/demo/age-and-sex/2022-older-population.html
4National Center for Health Statistic, Centers for Disease Control and Prevention (2022). Life Expectancy in the U.S. Dropped for the Second Year in a Row in 2021. Retrieved from:
https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220831.htm#:~:text=Other%20findings%20documented%20in%20the,2020%20to%2073.2%20in%202021.
5
Teno, et al. (2018) “Site of death, place of care, and health care transitions among US Medicare beneficiaries, 2000-2015.” JAMA 320.3: 264-271

8. Hospice History
• Linguistic root words:
– Hospital
– Hospitality
– Shelter
– Respite
– Caring
• A place of refuge and solace

9. Hospice History (cont.)
1967
Dame Cicely
Saunders
opened
St. Christopher’s
in London
1969
Publication of
“On Death and
Dying” by
Elisabeth
Kubler-Ross
brought
death and
dying into
the mainstream
1974
New Haven
Hospice of
Connecticut
established
1978
VITAS founded
1978
National Hospice
Organization
formed National
Hospice &
Palliative Care
Organization
(NHPCO)
Mission:
“To lead and
mobilize social
change for
improved care
at the end of life”
1982
President
Ronald Reagan
signed into law the
Medicare Hospice
Benefit, which was
capitated at
conservative rates,
making hospice
one of the original
risk-assuming
health entities

10. Palliative Care: Definition
National Hospice and Palliative Care Organization. (2020). Explanation of Palliative Care.
Retrieved from https://www.nhpco.org/palliative-care-overview/explanation-of-palliative-care/
Palliative care is patient- and family-centered
care that optimizes quality of life by anticipating,
preventing, and treating suffering. Palliative care
throughout the continuum of illness involves
addressing physical, intellectual, emotional,
social, and spiritual needs, and facilitating patient
autonomy, access to information, and choice.
– National Consensus Project for Quality Palliative Care

11. Explanation of Palliative Care
National Coalition for Hospice and Palliative Care. (2018). Clinical Practice Guidelines for Quality Palliative Care, 4th Edition.
Retrieved from https://www.nationalcoalitionhpc.org/wp-content/uploads/2018/10/NCHPC-NCPGuidelines_4thED_web_FINAL.pdf
• Palliative care is:
– Appropriate at any stage
in a serious illness
– Beneficial when provided
along with curative treatments
– Provided over time to patients
based on their needs
– Offered in all care settings
– Focused on what is most
important to the patient,
family, and caregiver(s)
– Interdisciplinary to attend
to the patient's holistic
care needs

12. Palliative Care
• Manages pain and symptoms
• Regards dying as a
normal process
• Neither hastens nor
postpones death
• Integrates psychological and
spiritual care
• Supports patient and family
• Incorporates a team approach
• Enhances quality of life
• Is applicable early in the
course of illness

13. Palliative Care: Clinical Expertise
• Symptom management
in advanced illness:
–Pain
–Dyspnea
–Nausea and vomiting
–Fatigue
–Anxiety and depression
• Care transitions and
coordination of care
• Goals-of-care/end-
of-life discussions
– Timely hospice
referral and admission

14. How Does Hospice Differ From Palliative Care?
Palliative Care
Hospice

15. Traditional Model
Continuum of Care - Traditional
Curative/Restorative Therapy
Presentation/
Diagnosis
Acute
Illness
Chronic
Death
End-Stage

16. Hospice/Palliative Care Interface
Robinson, et al. (2004). Assessment of the education for physicians on end-of-life care (EPEC™) project. Journal of Palliative Medicine, 7(5), 637-645.
Hospice
Curative/disease
modifying therapy
Time course
of illness
Last months
of life
Palliative care
Family
bereavement care

17. Palliative Care and Hospice Care

18. Eligibility
Palliative Care
• No prognosis requirements
Hospice
• 6 months or less on average,
should the advanced illness run
its normal and expected course
• Physician estimate
• Clinical determination

19. Reimbursement Mechanism
Palliative Care
• Fee-for-service
• Grants
• Member-based per month
(health plan contracted)
• Value-based insurance
design (VBID)
Hospice
• Medicare Part A
• Medicaid
• Private insurance
• Charity care

20. Location of Care
Hospice
• Patient home:
– Private residence
– Assisted living
– Long-term care
• Level of care:
– Routine home care
– Continuous care
– Inpatient care
– Respite care
Palliative Care
• Fee-for-service:
– Hospital
– Outpatient
– Skilled facilities
– Long-term care
• Member per month:
– Community-dwelling

21. 85%
7%
5%
1%
1%
1%
Medicare Hospice Benefit
Private Insurance/Managed Care
Medicaid Hospice Benefit
Other Payment Source
Self-Pay
Charity or Uncompensated Care
Who Pays for Hospice?
National Hospice and Palliative Care Organization. (2014). 2014 NHPCO Facts and Figures. NHPCO.org

22. Community-Based Palliative Care Demonstration Model
• Proposed by the National
Hospice and Palliative Care
Organization (NHPCO) and
National Coalition for
Hospice and Palliative
Care (NCHPC)
• Would be implemented by
Centers for Medicare and
Medicaid Innovation (CMMI)
• Expands interdisciplinary
care access to people with
serious illness nationwide
• Eliminates 6-month
prognosis requirement
• Aims to be proactive;
anticipates and preempts
future ED usage due
to decompensation

23. Professional Services
Palliative Care
• Depends upon the
goals and resources
of the program
• No regulatory
requirements
Hospice
• Core services:
– Physician
– Nurse
– Social worker
– Pastoral counselor
• Non-core services:
– OT/PT/speech
– CNA/aide
– Volunteer
• Additional support:
– Respiratory therapy
– Music, massage,
pet, etc.

24. Other Support
Palliative Care
• No required services
Hospice
• Medications
• Equipment
• Bereavement care
• 24-hour availability
• Supplies:
– Incontinence products
– Nutritional support
– Wound care products

25. The Symptom Burden of Serious Illness
Seale, et al. (1994). The Year Before Death. Beatty.
Symptom Cancer
Other
Illnesses
Symptom Cancer
Other
Illnesses
Pain 84% 67% Depression 38% 36%
Trouble breathing 47% 49% Loss of appetite 71% 38%
Nausea and
vomiting
51% 27% Constipation 47% 32%
Sleeplessness 51% 36% Bedsores 28% 14%
Confusion 33% 38% Incontinence 37% 33%

26. Early Palliative Care in Lung Cancer
Temel, et al. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, Aug 19;363(8):733-42.
0
10
20
30
40
50
HADS-D HADS-A PHQ-9
Standard Care Early Palliative Care

27. Concurrent Palliative Care in Metastatic Lung Cancer
Temel, et al. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, Aug 19;363(8):733-42.

28. Patients who die on hospice live
on average 30 days longer than
those who die without it.
Lung Cancer
CHF Colon Cancer
Comparing Hospice and Non-Hospice Survival
Connor, et al. (2007). Comparing hospice and non-hospice patient survival among patients who die within a three-year window. Journal of Pain Symptom Management, 33(3):238-46.

29. Palliative Care Programs: Center to Advance
Palliative Care (CAPC)
Center to Advance Palliative Care. (2020). The Case for Palliative Care. Retrieved from https://www.capc.org/the-case-for-palliative-care/
• Palliative care teams working
in hospitals:
– Improve patient and family
satisfaction with care
– Reduce 30-day readmission rates
– Reduce ICU utilization
– Can save 9-25% of costs for each
inpatient stay through a mixture of
shorter length of stay and reduced
cost per day
• Palliative care teams working in
home-based programs:
– Have been shown to save ACOs, health
plans, and health systems as much as
$12,000 per person enrolled
– Reduce emergency department visits,
hospital admissions, hospital
readmissions, and hospital length of stay
• Health plans that train case managers in
skills specific to this patient population and
who provide expanded access to specialty
palliative care have seen similar savings
while maintaining high rates of satisfaction

30. 0
200
400
600
800
1000
1200
Direct
Cost
per
Day,
$
0
200
400
600
800
1000
1200
1400
1600
1800
2000
-6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6
Direct
Cost
per
Day,
$
Days Before and After Palliative Care Consultation
Cost Savings Associated With US Hospital Palliative Care
Consultation Programs
Morrison, et al. (2008). Cost savings associated with US hospital palliative care consultation programs. Archives of Internal Medicine, 168(16):1783-1790.
Mean direct costs per day for palliative care patients who were discharged alive (A) or died (B) before and after palliative care consultation.
The solid line represents the regression curve of actual costs before palliative care consultation (day 0) and estimated costs (days 1-6) assuming
that palliative care consultation had not occurred. The dashed line represents direct costs per day for usual care patients for the 6 days before and
after hospital day 6 (patients with lengths of stay of ≤ 10 days), hospital day 10 (for patients with lengths of stay of 11-20 days), or hospital day
18 (for patients with lengths of stay of > 20 days).
Before palliative care consultation
After palliative care consultation
Day of palliative care consultation
A B

31. Cost Savings Associated With US Hospital Palliative Care
Consultation Programs (cont.)
Morrison, et al. (2008). Cost savings associated with US hospital palliative care consultation programs. Archives of Internal Medicine, 168(16):1783-1790.
Mean direct costs per day for patients who died and who received palliative care consultation on hospital
days 7, 10, and 15 compared with mean direct costs for usual care patients matched by propensity score.
Hospital day 1 is the first full day after the day of admission.
250
500
750
1000
1250
1500
1750
2000
1 3 5 7 9 11 13 15 17 19 21 23 25
Direct
cost
per
day,
$
Usual care Palliative care consultation day 10
Palliative care consultation day 7 Palliative care consultation day 15

32. CAPC Cost Impact Analysis
Center to Advance Palliative Care. (2020). The Case for Palliative Care. Retrieved from https://www.capc.org/the-case-for-palliative-care/
Palliative Care Reduces Avoidable Spending and Utilization in All Settings
48%
Readmissions
28%
Cost day
50%
Admissions
35%
ED visits
43%
Hospital
ED Transfers
36%
Total Costs
INPATIENT OUTPATIENT SKILLED NURSING HOME-BASED

33. Routine Care vs. Inpatient Palliative Care
Gade, et al. (2008). Impact of an inpatient palliative care team: A randomized control trial. Journal of Palliative Medicine, 11(2): 180-90.
Outcome Inpatient Palliative Care Routine Care
Care experience 6.9 6.6
Doctor/nurses communication 8.3 7.5
ICU admissions on readmission 12 21
MSPB 6-months –4,855/patient –
Median hospice stay 24 days 12 days

34. Where Do Patients Spend Their Last Days?
National Hospice and Palliative Care Organization. (2018). 2018 NHPCO Facts and Figures. NHPCO.org
50
25
25
Without Hospice
Hospital
Home
Nursing Facility
7
48
32
11
2
With Hospice
Hospital
Home
Nursing Facility
Hospice Unit
Residential Care Facility

35. Hospice Days of Care
National Hospice and Palliative Care Organization. (2022). NHPCO Facts and Figures. Available at: https://www.nhpco.org/wp-content/uploads/NHPCO-Facts-Figures-2022.pdf/
≤2 Days ≤5 Days
≤17 Days
≤79 Days
≤264 Days
0
50
100
150
200
250
300
10th 25th 50th 75th 90th
Hospice
length
of
stay
among
decedents
(in
days)
Percentile

36. Last Place of Care Experience
Teno, et al. (2004). Family perspectives on end-of-life care at the last place of care. JAMA 291.1: 88-93.
Outcome Hospice Nursing Home Home Health Hospital
Not Enough Help
With Pain, %
18.3 31.8 42.6 19.3
Not Enough
Emotional Support, %
34.6 56.2 70 51.7
Not Always Treated
With Respect, %
3.8 31.8 15.5 20.4
Enough Information
About Dying, %
29.2 44.3 31.5 50
Quality Care Excellent, % 70.7 41.6 46.5 46.8

37. Hospice Decreases Acute-Care Utilization
Kelley, et al. (2013). Hospice enrollment saves money for Medicare and improves care quality across a number of different lengths-of-stay. Health Affairs, 32(3):552–561.
0.00
0.10
0.20
0.30
0.40
0.50
In-hospital deaths ICU admissions 30-day hospital readmissions
Incremental
reduction
in
various
outcomes
(proportion) 53-105 days
15-30 days
8-14 days
1-7 days
Hospice enrollment:
0
2
4
6
8
10
Hospital Days ICU days
Hospital
and
ICU
days
avoided
53-105 days
15-30 days
8-14 days
1-7 days
Hospice enrollment:

38. Ongoing Demonstration of Hospice Quality Advantage
to Patient, Families, and Caregivers
Aldridge M., et al. (2022). Association between hospice enrollment and total health care costs for insurers and families, 2002-2018. JAMA Health Forum. 3(2), e215104-e215104).
Harrison, et al. (2022). Hospice Improves Care Quality For Older Adults With Dementia In Their Last Month Of Life: Study examines hospice care quality for older adults with dementia
in their last month of life. Health Affairs, 41(6), 821-830.
Kleinpell, et al. (2019). Exploring the association of hospice care on patient experience and outcomes of care. BMJ Supportive & Palliative Care, 9(1), e13-e13.
Kumar, et al. (2017). Family perspectives on hospice care experiences of patients with cancer. Journal of Clinical Oncology, 35(4), 432.
Wright, et al. (2010). Place of death: correlations with quality of life of patients with cancer and predictors of bereaved caregivers' mental health. Journal of Clinical Oncology, 28(29), 4457.
*Cancer patients, when comparing death in hospital to death in hospice **Compared to death in ICU ***Compared to hospital deaths
Families remarked patients received
just the right amount of pain
medicine and help with dyspnea
Families of patients receiving >30
days of hospice reported the most
positive EOL outcomes
Families more often reported patients’
EOL wishes were followed and rated
quality of EOL care as excellent
Family
Less risk for
PTSD with home
hospice deaths**
Home hospice reduced risk
for prolonged grief disorder***
Hospice admission in last 6 months
of life correlated with increases in
patient satisfaction and better pain
control, reductions in hospital days
Less physical and
emotional distress and
better quality of life at EOL*
Caregivers
Patients
60% reduction in end-of-life transitions, allowing patients to die in location of choice
Hospice beneficiaries saw
a cost savings of $670 in
out-of-pocket expenses
during the last month
of life compared to
non-hospice users

39. Total Cost of Care Comparison by Disease State and
Hospice Use in Last Year of Life*
*To be eligible to elect hospice care under Medicare, an individual must be entitled to Part A of Medicare and be certified as being terminally ill. An individual is
considered to be terminally ill if the medical prognosis is that the individual’s life expectancy is 6 months or less if the illness runs its normal course. Only care
provided by (or under arrangements made by) a Medicare certified hospice is covered under the Medicare hospice benefit. The hospice admits a patient only
on the recommendation of the medical director in consultation with, or with input from, the patient's attending physician (if any).
NORC at the University of Chicago (2023). Value of Hospice in Medicare. Available at: https://www.nhpco.org/wp-content/uploads/Value_Hospice_in_Medicare.pdf
Disease
Group
No
Hospice
Hospice
< 15 Days 15 – 30 31 – 60 61 – 90 91 – 180 181 – 266 > 266
ALL $67,192 4% -5% -9% -12% -14% -10% -12%
Circulatory $66,041 7% -4% -8% -10% -11% -8% -10%
Cancer $76,625 10% -1% -6% -9% -13% -14% -20%
Neuro-
degenerative $61,004 12% -6% -9% -11% -11% -5% -4%
Respiratory $77,892 -2% -11% -14% -17% -19% -18% -22%
CKD/ESRD $82,781 1% -14% -21% -24% -24% -23% -27%
• Hospice care saved Medicare
approximately $3.5 billion for
patients in their last year of life
• Those patients with hospice
stays of ≥ 6 months* yielded
the highest percentage
of savings
– For patients whose hospice
stays were between 181-266
days, total cost of care
was almost $7K less than
non-hospice users
– Hospice patients with stays
of > 266 days spent
approximately $8K less
than non-hospice users
Spending is greater than Spending is less than
non-hospice users non-hospice users
No difference / not
statistically significant

40. The Medicare Hospice Benefit Is a 6-Month Benefit: Quality and
Cost Evidence Corroborate the Need for Timely Access*
*To be eligible to elect hospice care under Medicare, an individual must be entitled to Part A of Medicare and be certified as being terminally ill. An individual is considered to be
terminally ill if the medical prognosis is that the individual’s life expectancy is 6 months or less if the illness runs its normal course. Only care provided by (or under arrangements
made by) a Medicare certified hospice is covered under the Medicare hospice benefit. The hospice admits a patient only on the recommendation of the medical director in
consultation with, or with input from, the patient's attending physician (if any). under the Medicare hospice benefit. The hospice admits a patient only on the recommendation
of the medical director in consultation with, or with input from, the patient's attending physician (if any).
NORC at the University of Chicago (2023). Value of Hospice in Medicare. Available at: https://www.nhpco.org/wp-content/uploads/Value_Hospice_in_Medicare.pdf
Over the last 12 months
of life, as hospice use
increases, total spending
decreases relative to
non-hospice users.
The reduction in costs
when patients across all
disease classes, including
neurodegenerative
diseases, use hospice
can be significant.

41. Reasons for Readmission
• Failure in discharge planning
• Insufficient outpatient and
community care
• Advanced, progressive illness

42. Care Transitions

43. Medicare Hospice Benefit
Interdisciplinary Team of
Hospice Professionals
Home Medical
Equipment
Medication Bereavement
Support
Continuous
Care
Respite Care
Inpatient Care
Routine
Home Care
These Services Are Mandated by the Medicare Hospice Benefit

44. 1. Routine home care 98.7%
• Most common level of hospice care
• More robust and comprehensive
compared to home health
care services
• Patient’s preferred setting
• Proactive clinical approach helps
prevent ED visits/hospital readmissions
2. Intensive Comfort Care®
(continuous care) 0.2%
• Medical management in the home
for up to 24 hours per day for
acute symptom management
when medically appropriate
3. Inpatient care 1.0%
• For symptoms that cannot be
managed in the home
4. Respite 0.2%
• Provides a temporary break
for primary caregiver
• Inpatient setting
• Up to 5 days of 24-hour patient
care management when
medically appropriate
Four Levels of Hospice Care
National Hospice and Palliative Care Organization. (2022). Facts & Figures: Hospice Care in America. Available at: https://www.nhpco.org/hospice-care-overview/hospice-facts-figures/

45. Interdisciplinary Hospice Team
Patient and
Family
Volunteers
Physicians
Spiritual
Counselors
Social
Workers
Bereavement
Counselors
Hospice
Aides
Therapists
Nurses

46. Hospice: Right Care at the Right Time
Hospice Palliative Care Home Health
Eligibility Requirements
Prognosis required: ≤ 6 months
if the illness runs its usual course
Prognosis varies by program,
usually life-defining illness
Prognosis not required
Skilled need not required Skilled need not required Skilled need required
Plan of Care Quality of life and defined goals Quality of life and defined goals Restorative care
Length of Care Unlimited Variable Limited, with requirements
Homebound Not required Not required Required, with exceptions
Targeted Disease-Specific Program ✓ Variable Variable
Medications Included ✓ X X
Equipment Included ✓ X X
After-Hours Staff Availability ✓ X X
RT/PT/OT/Speech ✓ X ✓
Nurse Visit Frequency Unlimited Variable Limited, based on diagnosis
Palliative Care Physician Support ✓ Variable X
Levels of Care 4 1 1
Bereavement Support ✓ X X

47. Bereavement
Support groups
Bereavement specialists offer
support for a minimum of
13 months following a death
Individual grief support and
grief education resources
Memorial activities

48. Hospice Impact: Satisfaction
Kumar, P., et al. (2017). Family perspectives on hospice care experiences of patients with cancer. Journal of Clinical Oncology, 35(4), 432.
• Hospice care is associated
with better symptom relief,
patient goal attainment, and
quality of EOL care.
• Families of patients enrolled
in hospice more often reported
that patients received “just
the right amount” of pain
medicine and help with dyspnea.
• Families of patients enrolled
in hospice also more often
reported that patients’ EOL
wishes were followed and EOL
care was “excellent.”
• Families of patients who
received > 30 days of hospice
care reported the highest
quality EOL outcomes.

49. Hospice: In Conclusion
• Hospice is:
– A service, not a place
– Provided in the patient’s preferred
setting, whether
a private residence, nursing home,
assisted living facility, or inpatient
hospice setting
– Care that comforts and supports
when an advanced illness no longer
responds to curative treatments
– Making the most of the time
that remains
– Covered by the Medicare
Hospice Benefit

50. Summary
• Palliative care supports persons with advanced
illness and facilitates more timely hospice referral
• Hospice and palliative care support:
– Patients and families
– Clinicians
– Hospitals and health systems
• All successful palliative care programs
partner with a hospice

51. Partner With Hospice
“You matter because you are you.
You matter to the last moment of life, and
we will do all we can, not only to help you
die peacefully, but also to live until you die.”
—Dame Cicely Saunders
St. Christopher’s Hospice London, England

52. Questions?

53. Additional Hospice Resources
The VITAS mobile app includes helpful
tools and information:
• Interactive Palliative Performance
Scale (PPS)
• Body-Mass Index (BMI) calculator
• Opioid converter
• Disease-specific hospice
eligibility guidelines
• Hospice care discussion guides
We look forward to having you attend
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54. References
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57. Palliative Care vs. Curative Care