What is the difference between hospice and palliative care?
Hospice is comfort-focused care for someone with a life-limiting illness, generally when a physician certifies a prognosis of six months or less and the patient chooses comfort over curative treatment, while palliative care relieves symptoms and stress at any stage of a serious illness and can be given alongside treatment meant to cure.
Palliative teams often work out of hospitals and specialty clinics; hospice teams come to wherever the patient lives.
| Hospice | Palliative care | |
|---|---|---|
| When | Prognosis of about six months or less | Any stage of serious illness |
| Curative treatment | Stopped for the terminal illness | Can continue |
| Where | Wherever the patient lives | Usually clinics and hospitals |
Can hospice be provided in a Richmond assisted living facility or nursing home?
Yes. Hospice care is delivered where the person lives -- at home, in an assisted living facility, in a nursing home or in an inpatient hospice unit -- and the hospice team works alongside facility staff, but the hospice benefit does not pay the facility's room and board.
Ask the facility whether it has worked with the hospice you prefer and how it coordinates medications and night calls.
Who pays for hospice and palliative care?
Medicare's hospice benefit covers the hospice team, medications related to the terminal diagnosis, equipment and supplies, while palliative care is billed like other medical care under Medicare Part B, Medicaid or private insurance, with the usual cost-sharing.
A patient can leave hospice and return to curative treatment, and can change hospice providers.
How do Richmond families start hospice or palliative care?
Either can start with a conversation with the patient's doctor or hospital team: palliative care through a referral to a palliative medicine clinic or hospital consult service, and hospice through a referral to a Medicare-certified hospice agency, which then confirms eligibility with its medical director.
Families can also call a hospice directly and ask for an informational visit; there is no obligation, and the visit is a good way to understand what the team would provide at home, in an assisted living facility or in a nursing home.
If the patient lives in a facility, involve the facility early. Assisted living staff remain responsible for daily care between hospice visits, so ask how they coordinate comfort medications, night-time calls and the plan for the final days, and whether they have worked with that hospice before.
Bereavement support for the family is part of the Medicare hospice benefit and continues after the patient's death; ask what form it takes.
Is palliative care available for people living in Richmond assisted living?
Yes. Palliative care can be provided to residents of assisted living or nursing homes through their doctors or a palliative care team, alongside other treatment, without electing hospice.
Ask the resident's physician for a referral and ask the facility how visiting clinicians coordinate with its staff.
