Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home. Medicare , Medicaid , and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs.
Private health insurance might pay for some services. Health insurance providers can answer questions about what they will cover. Visit the National Hospice and Palliative Care Organization website to find palliative care near you.
In palliative care, a person does not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. Over time, if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities. Palliative care could transition to hospice care if the doctor believes the person is likely to die within six months see What does the hospice six-month requirement mean?
Or, the palliative care team could continue to help with increasing emphasis on comfort care. Increasingly, people are choosing hospice care at the end of life. Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life. At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments.
Hospice is designed for this situation. The patient beginning hospice care understands that his or her illness is not responding to medical attempts to cure it or to slow the disease's progress. Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person's illness are stopped.
Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course. It's important for a patient to discuss hospice care options with their doctor. Sometimes, people don't begin hospice care soon enough to take full advantage of the help it offers. Hospice is a specific type of palliative care for people who likely have 6 months or less to live. In other words, hospice care is always palliative, but not all palliative care is hospice care.
Palliative care is provided by an interdisciplinary team that may include a doctor who specializes in palliative medicine , a nurse, pharmacist, social worker, dietitian, and volunteers. Your other doctors focus on your general health or treating your disease or condition. Palliative doctors concentrate on preventing and alleviating suffering, improving your quality of life, and helping you and your loved ones cope with the stress and burden of your illness.
Yes, of course. But palliative doctors have special training and expertise in pain management and symptom control, and specialize in helping patients and their families cope with the many burdens of a serious illness, from the side effects of a medical treatment to caregiver stress to fears about the future.
Palliative doctors can assist you with difficult medical decisions, helping you weigh the pros and cons of various treatments. Your palliative doctor coordinates care with your other doctors and helps you navigate the often-complex healthcare system. Insurers and Medicaid agencies will provide coverage for hospice care if your doctors determine you likely have 6 months in some cases a year or less to live if your illness follows its normal course. However, it is your own choice to enter or leave hospice care.
If your illness improves or you wish to seek curative treatment, you may leave hospice care, returning if and when you choose to. This might, for example, include navigating emotional challenges or managing pain. This is when hospice can be of great service. If faced with such a decision, it is important to know exactly what hospice care is and the services it can provide to you and your family. Hospice is not necessarily a place or an institution where you go.
It is a philosophy of care that addresses the needs of patients and their loved ones when life-extending treatments are no longer beneficial or desired. Hospice care is typically provided wherever the patient lives. It may their home or in a nursing home , assisted-living center , hospice inpatient facility , or even a hospital. Regardless of the location, care will be delivered by both trained hospice volunteers and an interdisciplinary team of health professionals including healthcare providers, nurses, social workers, hospice aides, and others.
In accordance with the law, services rendered under the Medicare Hospice Benefit may include:. The hospice team will continually evaluate the patient's condition and revise their care plan as needed. Hospice care also provides practical support to family members and loved ones during this difficult time. The team can assist with funeral planning or memorial services.
Many people regard hospice as a service available to only those with end-stage cancer. According to the National Hospice and Palliative Care Organization NHPCO , however, the majority of people admitted to hospice in had a non-cancer diagnosis, such as one for heart disease, lung disease, stroke, or coma.
Another widely held misconception is that those entering hospice have given up hope or "want to die. The overall mission of a hospice provider is to affirm life. By viewing death as part of a natural process, patients are allowed to spend the remainder of their days as fully and as comfortably as possible. The terms palliative care and hospice care are often used interchangeably, but they are not the same. While both focus on reducing pain and improving the overall quality of life, palliative care can be administered at any time and for as long as deemed necessary for someone dealing with a chronic or life-threatening condition.
For example, someone with stage 4 breast cancer might receive palliative care to treat the side effects of the very treatments such as chemotherapy or radiation used to extend life. The same might apply to someone with secondary progressive multiple sclerosis , advanced Alzheimer's disease , or stage 4 emphysema.
In contrast, hospice care is a more limited-duration form of care, as it is for those known to be approaching the end of life. It is possible that a patient may transition from palliative to hospice care at some point. A healthcare provider can help you understand if palliative or hospice care is more appropriate for you or your loved one, and the decision will hinge on the patient's condition and needs.
To be eligible for the benefit, you or your loved one must:. Medicare defines four levels of hospice care :. Prior to admission, the treating practitioner and hospice provider will select the level appropriate to the individual's needs. As those needs change, the level of care can be adjusted. A healthcare provider can recertify a patient for the Medicare Hospice Benefit if their condition continues to decline but they had lived longer than six months. In addition to Medicare, many private health insurance plans offer hospice benefits, as do state Medicaid programs.
Because the benefits can vary from one insurer or policy to the next, it is important to understand what is and is not covered under your plan. This is especially true with regard to Medicaid. While many assume that Medicaid works in the same way as Medicare since they are regulated by the same federal agency, the Centers for Medicare and Medicaid Services , what is offered can vary by state. The Medicaid Hospice Benefit is an optional state plan for low-income individuals or those with a disability.
While all states offer some form of hospice benefit, some place a limit on what you can receive, while others require a copayment for services. To qualify, you must file an election statement waiving further treatment of a terminal condition. The only exception is for people under 21 who can opt to receive both hospice and ongoing curative treatment.
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