Benefits of Hospice and Palliative Care
by Felicia Juntunen, CMC, ECM Director of Care Management
Among the many privileges of care management work is the opportunity to journey with clients to the end of their lives. Because we spend time developing familiarity with our clients, regularly provide advocacy for their care, and understand what their priorities are for their well-being and quality of life, they trust us to contribute to the conversation about end-of-life care. We provide insight and guidance to help families determine when it’s time to consider palliative care or hospice as an option for their loved one.
The primary difference between palliative and hospice care is their curative intent. Both levels of care emphasize relief from pain and other symptoms of a serious illness, but with hospice, attempts to cure a person’s illness are no longer pursued; the comfort of the patient is the sole focus.
To qualify for hospice, a patient must have a diagnosis that their physician believes is terminal, with a life expectancy of six months or less, or the patient is in the end stages of Alzheimer’s Disease or another dementia. Hospice care provides a team of professionals trained to address the physical, psychosocial, and spiritual needs of the person and provide support to family members. Services are delivered to the patient where they reside and include weekly nursing visits, a home health aide who helps with bathing, and chaplaincy and social worker visits, if desired. Importantly, hospice providers are available to respond 24 hours a day, 7 days a week if concerns arise. Hospice agencies provide bereavement care to patient families. Hospice is a fully covered benefit under Medicare and is covered under most insurance.
Palliative care is specialized medical care with a focus on providing relief from symptoms of an illness while improving the quality of life for the patient and those caring for them. Palliative care, unlike hospice, is based on the needs of the patient and not their prognosis, and services can be provided along with curative treatment options. Like hospice, palliative care teams include physicians, nurses, social workers, and chaplains, and may also include nutritionists and other professionals who offer support to patients. Unlike hospice, palliative services may be limited, according to the patient’s needs. Most palliative care programs are run by hospice agencies. Palliative care is often covered by Medicare, other insurance, or non-profit hospice agencies.
Care managers can assist families in recognizing changes in their loved one that may indicate a need for the kind of support offered by either palliative or hospice care. Because a care manager develops familiarity with and regularly monitors a client’s situation, we often recognize when there is a significant decline in their physical or cognitive status. We can help a client and families understand they don’t have to be in the final days of life to receive hospice care but can receive care early and take advantage of the many benefits hospice and palliative care can offer. For a patient whose family may be unavailable, a care manager can provide the hospice agency with important information about the client. Elder Care Management care managers collaborate with hospice agencies as they deliver care to their patients, and we are grateful to the hospice community for the enhanced quality of life and comfort they provide our clients.