Taking care of a loved one with a serious illness can be a confusing time that leads to a number of high-stakes questions. Do they require end-of-life care? Do healthcare plans provide for long term treatment? What are the options?
Local services can help to answer these tough questions relating to both palliative care and hospice, two healthcare options with differences and distinctions that are often not fully understood. Two local experts help to delineate the differences between these two care approaches, as well as expectations for you or your loved one who may require one (or both) of those services.
Palliative care
ProMedica Senior Care Director of Palliative Care Services Mary Beth Quinn, BSN, RN, CHPN, explains that palliative care offers a broad scope of care in conjunction with curative treatments for people with long term, serious illness. “You can continue to receive chemotherapy for cancer while the palliative team will assist you as you manage the side effects of your treatments,” Quinn says. “Palliative care can also be provided contemporaneously with home health services if the patient qualifies and would benefit from those services as well.” It’s important to check with your individual healthcare plan to determine whether the care you receive will be paid in full, or if you can expect a co-pay for each visit.
Besides cancer, other serious long term illnesses that may make patients good candidates for palliative care include ALS, heart disease, COPD, and other health issues that significantly affect quality of life. Hospice of Northwest Ohio Chief Medical Officer and Medical Director Dr. Marsha Paul considers palliative care to be “an underused service,” possibly because people aren’t as aware of its benefits as they are about those of hospice.
“Palliative care services are done in the hospital, at home, or in clinics,” explains Dr. Paul. “And it’s a team approach that involves a social worker and an RN care coordinator— someone who is answering the phone and helping to make sure your questions are answered.”
Your first visit might be with a physician, but you might have follow-ups with a nurse practitioner or a social worker that helps you find out if you’re eligible for Meals on Wheels and other supplemental programs to promote wellness. It’s a holistic approach that involves many intersecting healthcare professionals.
Hospice
While hospice also has a team-based approach to treating patients, it is specifically for terminally ill patients. “Hospice care is appropriate for patients with a life-limiting condition who are no longer seeking curative treatment, and they have a prognosis of six months or less to live,” says Quinn, adding that there are other factors to be considered to evaluate eligibility. Multiple ER visits and hospitalizations, unintentional weight loss, altered mental status, and other factors will be looked at when considering hospice as an option.
Payment for hospice is covered in full by both Medicare and Medicaid. Most insurances and the Veteran’s Administration will often cover hospice care in full, or minimal co-payments may be required..
Quinn wants to clarify that people “don’t have to be in the last days or weeks of life to qualify for hospice care. Our care is about living well in the time you have left. The sooner you call us, the better you’ll live,” she says, adding that hospice patients live longer and feel a sense of control over their lives. Hospice services also provide a break for full-time caregivers and the patient’s family. You can also leave hospice and return as needed. There is flexibility when it comes to receiving hospice care and palliative care.
No need to wait
Dr. Paul wishes that people would learn about their options sooner. “The sooner you get on one of the programs, the better,” she says. “The sooner you’re seen by palliative care about symptoms, then the better we can help get those symptoms under control so you can have a better quality of life. Then, if that person’s condition becomes terminal, the nurse practitioners recognize, and can suggest, that it might be time to switch over to hospice. That provides input for the patient from professionals that he has a relationship with and the patient is not quite as afraid.”
It’s an empowering thing to educate oneself about hospice and palliative care rather than silently waiting with avoidant trepidation for a physician to suggest end-of-life options. Helping yourself, or your loved one, take control of their own healthcare journey is always preferable to being fearful of what is to come.
What most families need are the supportive teams that can be found within palliative and hospice care, both of which are available locally. To find out more, visit hospicenwo.org and heartlandhospice.com.
