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Hospice and Palliative Care: Do You Know The Difference?

by Gretchen Gaines, LICSW, Seabury Care Manager, and Christine Bitzer, LICSW, Assistant Director, Seabury Care Management

Hospice care is a comprehensive health care service available to a person who has a serious illness near the end of life. It focuses on more than just the medical needs of the patient, offering the patient comfort care, as well as supportive services for the patient, family, and friends, including bereavement services. Services are usually provided in a patient’s home, or the community where they reside. Initially a team of hospice specialists are introduced including a nurse, a social worker, a volunteer, a chaplain, and other caregiving services.

Pain management is an important aspect of hospice care. Reduction of pain is a specialty of hospice professionals. And comfort for the patient, family, and friends is a priority. This is provided by the team, and often will include complementary therapies, such as music therapists, art therapists, and other skilled professionals.

Hospice care is paid for by the Medicare Hospice benefit, private insurance and Medicaid, whichever is appropriate. Round-the-clock care for patients is not covered. A patient or a family member may access the care by inquiring about hospice or it may be suggested by the physician (physician referral is required). Generally this happens when it is determined by the patient’s physician that there are no further treatments available and no cure is available or wanted.

Services provided by hospice agencies can vary and as an informed consumer it is important to ask questions about the availability of specific services that are important to you. In addition, be aware that there are for-profit and non-profit hospice programs.

Details are available at U.S. Department of Health and Human Services website.

Palliative care - Palliative care is a more recent specialty that has developed due to the increasing incidence of chronic health conditions and the accompanying pain. Prior to end of life or terminal illness care, palliative care centers offer pain consultation and reduction with additional support services. These services address the emotional, psychological and other aspects of suffering of both the patient and family/friends.

Questions to consider when looking at hospice:

  • Is a chaplain available whether or not we have regular attendance/membership in a faith community (i.e. a synagogue, church, mosque?)

  • How are bereavement services provided? What do they include?

  • Will follow-up nursing visits for the patient’s physical care be done by the same nurse who first visited? How long will we wait for other hospice staff to come to visit with us? Are frequent ongoing visits offered for social work, chaplains available so that a relationship can be developed with the patient and caregivers?

  • Is a social worker available to help my loved one with end of life discussions or concerns? Or will another staff member address those concerns? Are they also available for family and friends?

Care Management

A Seabury care manager usually has intimate knowledge of a client’s goals with regard to how they want to live their life, including end of life, as well as an understanding of their health and how the two may intertwine. As such, she may make a recommendation of hospice care to a family or she may provide the family with an idea of when it may be suggested by the physician. The care manager’s role is also to provide support and guidance as the family and client discern if hospice is appropriate, and if it is, coordinate with the providers and advocate on the client’s behalf, as we do with any service. Click here to learn more about Seabury Care Management.

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