Palliative Care vs Hospice
Although both palliative and hospice maintain similar purposes for easing the pain and discomfort of the patient, the expectations and objectives of treatment often diverge from one another. The main difference between palliative care and hospice hinges upon the curative intent of treatment.
Hospice provides care at a point in time when the patient’s diagnosis no longer supports the belief that he or she can be cured of their illness or disease and the only remaining, humane option is to focus solely on the symptoms. Specifically, relief from the pain or discomfort that comes with the symptoms.
Palliative care is provided to a patient who may still have the opportunity of being cured of his or her illness. However, palliative care may also be given if the patient has reached the final phase of a disease and curative care is no longer possible.
Yes, the two are similar and that can make it confusing for patients and their family, friends, and other stakeholders to figure out which type of treatment is best. Comfort care is at the heart of both forms of treatment, but there are distinctions among them related to who is eligible for which type of care and the methods by which care is paid for and by whom.
Eligibility for Palliative vs Hospice Care
Any patient seeking out hospice care has to meet certain criteria for eligibility to receive it. The patient must first decide to discontinue pursuing curative care intended to treat his or her terminal illness. The prognosis of the patient must be six months or fewer, certified by two physicians as to that effect. Therefore, hospice care is ideal for a patient who does not have much time left and is suffering through intense consistent pain and discomfort.
A patient who would like to enter palliative care is not required to meet these same eligibility requirements. The physician and the patient are able to decide if and when to pursue palliative care, even if the illness has not been deemed terminal.
In both instances, comfort care is priority one. That means relief from the pain and suffering brought on by the symptoms of the illness for both the physical and mental well-being of the patient.
Differences in Providers of Care
Regardless of whether the patient enters hospice or choose palliative care throughout the course of his or her illness, there is a diverse team of professionals assigned to address the challenges that come with the disease.
In both types of care, the patient is tended to by a group of skilled professionals comprised of doctors, nurses, specialists, social workers, spiritual advisors, nutritionists, and trained assistants who are qualified to administer treatment. The team targets the physical pain of the symptoms due to illness, but also the emotional and psychological challenges that come with it.
The hospice care team works closely with the patient and caregivers while ensuring the family has an important voice in all matters related to the well-being of the patient. All decisions are made with the consideration of the patient’s current condition in mind for alleviating pain and discomfort. Treating the symptoms is their first priority. One or more members of the team will visit the patient on a routine basis and someone is typically available for consultation via telephone or remote video at all times.
The palliative care team is also tasked with providing relief from the symptoms of an illness, whether or not a terminal diagnosis has been given. The level of care and the number of individuals involved can vary while decisions are made with the input of all stakeholders in the health and well-being of the patient.
Payment for Care
The costs of hospice are covered entirely by Medicare, Medicaid, or through a private insurer. This is why eligibility criteria is so stringent and specific. Medicare covers all of the costs associated with care, from prescriptions and medical equipment to round the clock access to care as well as all other services of hospice. These include nursing care, social services, and grief counseling after the death of the patient due to terminal illness.
Palliative care costs work a little differently from hospice in that paying for care tends to vary based on how much and what type of care is offered by the patient’s care provider and health insurer. Palliative care costs may be covered by Medicaid and Medicare Part B, but expenses might not be paid in full by either. The patient may be responsible for co-pays on treatment and prescriptions. Private insurers may also have limits or restrictions based on the policy of the patient. As always, contact the insurance company first to determine limits of coverage and which costs, if any, will be made out-of-pocket.