Often, the family of a terminally ill loved one stays in denial and needs ample time to accept that the final goodbyes are close. In such times, anyone in charge of the patient wants to do everything to minimize patient pain and distress.
Even when the sickness is not terminal, nobody wants to leave their loved ones unattended. Such patients may need around-the-clock professional medical care to cope with their illness and live as normally as possible.
One can get licensed medical care for a severe or terminal illness at a hospital, private clinic, skilled nursing facility, or home. It all comes down to the patient’s condition and the availability of the necessary treatment facilities. For instance, a patient undergoing radiotherapy for cancer cannot have their treatment done at home and would instead be admitted to a medical facility.
The goal of any field of medicine is to maintain and improve the quality of life of a patient suffering from lifelong diseases. Or to allow a patient to leave the world as comfortably as possible in cases of terminal illnesses. In such cases, patients either need palliative care or hospice care.
The Difference Between Hospice Care and Palliative Care
What is Hospice Care?
Hospice care is a particular medical treatment provided to a patient approaching death. The goal of hospice care is to maximize the patient’s comfort and help them cope with their pain and distress. Hospice care targets terminally ill patients and focuses on providing emotional support to the patient’s family or friends.
Families receiving hospice care can improve their quality of life and cherish the last moments spent with their loved ones. It helps them cope with depression, physical pain, and post-death loneliness.
Only patients suffering from life-limiting diseases can receive hospice care. A healthcare professional can officially conclude if a person’s illness is terminal and whether they need hospice care or not. A patient can receive hospice care at their home or a skilled medical facility.
To qualify for Medicare, a patient needs to have a life expectancy of six months or less. Only a licensed doctor can attest to the patient’s fatal condition. Medicare will only cover the at-home hospice care if the doctor can confirm the patient’s homebound status.
What is Palliative Care?
Palliative care is a medical treatment that targets patients suffering from serious diseases. For palliative care, the nature of the condition does not have to be fatal. Still, it needs to be sufficiently severe to require around-the-clock medical attention.
Apart from the patient, palliative care is designed to provide support and coping mechanisms to caregivers. Patients in palliative care may get their symptoms addressed or receive medication along with palliative care to restore health. Palliative care is usually provided at the patient’s home; however, caregivers can offer it at any legal healthcare facility.
Medicare will cover palliative care if a licensed doctor can attest to its need. Medicare will only cover the at-home palliative care expenses if the doctor can verify the patient’s homebound status.
Difference Between Hospice Care and Palliative Care
Hospice care and palliative care are unique medical treatments to help patients cope with their illnesses. Different parts of Medicare can cover a patient’s hospice or palliative care needs. Moreover, both medical treatments can be provided at the patient’s home, the hospital, or a skilled medical facility depending on the patient’s condition and preference.
Despite the many similarities, hospice care and palliative care have different purposes, patients, and care methods. The significant differences are as follows:
- Hospice care is specially designed for patients who are suffering from life-limiting diseases. Usually, the life expectancy for receiving hospice care is less than six months.On the other hand, palliative care is intended to treat patients suffering from life-threatening illnesses.
- The purpose of hospice care is to help the patient cope with pain, physical distress, and depression. In contrast, palliative care treats the patient’s symptoms and illness.
- A patient can continue to receive palliative care treatment for several months and years. However, the caregivers will not continue the hospice care treatment beyond six months.
- Medicare will cover palliative care expenses for the complete treatment. However, it will not continue to pay for hospice care after six months.
- When receiving palliative care at home, skilled healthcare practitioners are required. On the contrary, apart from trained medical staff, a family member can also be trained to become the primary caregiver for at-home hospice care.
What Are the Four Levels of Hospice Care?
When a person is reaching the end of their life, they need more care, support, and attention. Suffering from a fatal illness is not easy on the physical body and mind. However, hospice care treatment can allow the patient’s final months to be more comfortable and bearable.
With the right kind of hospice care, many patients choose to celebrate their last moments by going through with their bucket list and staying close to their loved ones.
To lower the stress on the patient and their families, Medicare is designed to shoulder the financial burden of receiving hospice care. After an in-depth analysis of the patient’s condition, Medicare will select the appropriate level of hospice care that a patient requires.
The four different levels of hospice care as defined by Medicare are as follows:
Level 1: At-home Hospice Care
A patient certified by a doctor to receive at-home hospice care will undergo regular checkups and treatment from the comforts of their home to reduce the pain and increase comfort. The hospice care routine treatments may include therapy, pain, symptom relief, and emotional counseling for patients and their families.
Moreover, one can call hospice care providers to provide the necessary treatment or assistance. Usually, they do have a fixed visiting schedule to follow. The caregivers may help the patient carry out everyday tasks such as using the bathroom, bathing, eating, and sleeping.
Level 2: Continuous Hospice Care
Continuous hospice care is also referred to as crisis care due to its severity. Terminally ill patients cannot function without the constant support and medical assistance. They require continuous hospice care. This level of hospice care involves around-the-clock intensive medical aid, and the professional caregivers are not allowed to leave the patient’s side. If continuous hospice care is provided at the patient’s home, the caregivers must reside at the patient’s residence with them. However, this only happens when the patient is certified to be medically homebound.
Continuous hospice care is especially beneficial to the patient’s family, who otherwise struggle to be available 24/7. Moreover, at-home constant hospice care allows the family members to learn how to help the patient when assistance is unavailable. Furthermore, the distributed responsibility allows the family the freedom to continue their daily routines.
Level 3: Inpatient Hospice Care
When at-home treatment cannot manage a patient’s pain and symptoms, they have no choice but to go for inpatient hospice care. An inpatient facility could be a hospital, a private clinic, or an independent center that allows the patient’s family to visit conveniently.
Inpatient hospice care aims to relieve pain, distress, and discomfort. Due to its homelier ambiance, many patients prefer to stay at an independent inpatient center rather than a hospital.
Level 4: Respite Hospice Care
Respite hospice care allows the inpatient hospice centers to house the patients for limited stays. The need for respite hospice care arises when a patient’s disease takes a sudden turn for the worse or when the patient’s family cannot temporarily provide assistance.
What Illnesses Does Hospice Cover?
To receive hospice care, the nature of the patient’s disease has to be terminal, with a life expectancy of six months or less. The following are some of the many illnesses that qualify a patient for receiving hospice care:
Cancer
If the patient’s cancer is in the treatable stage, they are provided with palliative care instead of hospice care. However, suppose the person’s cancer has progressed to the final fourth stage. In that case, hospice care is provided to manage pain, symptoms, physical distress, and emotional support. Cancer will only be considered terminal after the licensed doctor can provide the necessary evidence.
Parkinson’s Disease
Parkinson’s disease is a brain disorder that affects posture, balance, and mobility. When a patient enters the final fifth stage of this disease, they are often untreatable. This is when hospice care comes in to ensure the patient has sufficient medical assistance to cope with the pain and poor posture when entering their final days.
Renal Disease
Terminal renal or kidney disease occurs when the kidneys lose their function and shut down completely. Hospice care is necessary when the patient can no longer survive on dialysis and has no kidney donor.
Heart Disease
When a doctor can clinically conclude the terminal condition of a patient’s heart disease, hospice care is provided. This usually happens when the damage to the heart muscle is severe enough to cause it to fail or when all the heart’s major arteries are blocked. Patients die from heart failure within 3 to 4 months without an emergency transplant.
Who Gets Palliative Care?
Palliative care becomes a viable option when a person’s illness is severe enough to be life-threatening but can be cured. Palliative care is usually provided during the early stages of a patient’s disease. Patients who do not get cured of palliative care have to shift to hospice care for the terminal phase of their disease. The patients who qualify for receiving palliative care are as follows:
- Cancer patients whose disease has yet not progressed to the final terminal stage. Patients may receive pain medication, chemotherapy, radiotherapy, surgical treatment, and palliative care. The cancer patient’s palliative care treatment would also involve mental therapy to help cure the person’s depression.
- People who have AIDs that is yet not in their terminal stage. Palliative care would work alongside the patient’s medical treatment and help manage the patient’s pain, symptoms, and emotional distress.
- Patients suffering from lung or renal diseases that, although severe, can still be treated. Palliative care would be beneficial for managing the symptoms and discomfort during the treatment and after a transplant.
What Are the Four Types of Palliative Care?
Palliative care provides people hope and a chance to restore their health. It helps manage the physical discomfort and helps boost the patient’s morale for recovery.
The four types of palliative care are:
At-home Palliative Care
When a patient is certified by a doctor to be medically homebound due to the nature of their illness, the patient can receive palliative care treatment for their pain, symptoms, and mental health from the comforts of their home.
Moreover, the palliative care providers have pre-decided daily visit schedules. However, the program could be changed due to an emergency.
Palliative Care at Care Home
Suppose a patient does not have a home or good help to receive the treatment at their residence. In that case, they can choose to go to a nursing facility or a care home for their palliative care treatment. Many patients prefer a care home over a hospital due to its homelier ambiance.
Hospital Palliative Care
If a patient needs intensive, around-the-clock palliative care, they must shift to a hospital. A care provider is required to assist the patient at all times.
Day Care at a Hospice Center
Taking care of a recovering patient can be an extremely time-consuming task. Family members who have occupational responsibilities or need to leave town can drop the patient at a hospice center for palliative care treatment. The patient’s stay is short and could be for a few hours or days, depending on their family’s schedule.
Final Thoughts
Coming to terms with accepting your terminal or life-threatening disease could be stressful for both you and your family. Not only would you need medication for pain and symptom management, but you would also require psychological support to cope with the stress.
Hospice care provided by trained professionals can make your final days more bearable for you and your family. In contrast, palliative care is crucial for fighting a disease that could otherwise become terminal.
