November is National Hospice and Palliative Care Month. This month exists to raise awareness of hospice and palliative care and the needs of those living with life-limiting illnesses. Many people are reluctant to enlist the services of hospice or palliative care, because they see it as “giving up.” In truth, hospice/palliative care is a compassionate response to someone who is terminally ill and/or living in pain.
Hospice Care vs. Palliative Care
Hospice and palliative care share many things in common, the most important of which is improving a patient’s quality of life by treating pain and managing other symptoms. Both seek to improve a person’s physical, emotional and spiritual well-being. The difference is that people receiving hospice care have chosen to discontinue curative treatments and, instead, are focused on creating a time of comfort and dignity. Hospice is a type of palliative care. People receiving non-hospice palliative care may still be seeking curative treatments.
The Benefits of Palliative Care
There is no denying palliative care’s track record in improving – and even extending – life. In a study from the University of Pittsburgh School of Medicine and published in the Journal of the American Medical Association, researchers discovered that people living with serious illnesses who receive palliative care have a better quality of life and fewer symptoms. Palliative care may go beyond that by actually extending life. In another study, published in the Journal of Clinical Oncology, 63 percent of the patients who started palliative care immediately after a diagnosis of advanced cancer were alive after one year, while only 48 percent of the patients who started palliative care three months after diagnosis were alive after one year. But the good news doesn’t stop there. In a more recent study, published in the Journal of the American Medical Association, researchers discovered that palliative care not only improves quality of life, it shortens hospital stays and lowers medical costs. One study found that palliative care saved patients who were eventually discharged an average of $1700.
When is Palliative Care Appropriate?
As the Oncology study above suggests, the sooner palliative care begins, the better. Early care may also help caregivers. In a study published in The Oncologist, researchers noted that early integration of palliative care into a patient’s oncology care plan improves quality of life, symptom burdens and depression. The study sought to find out the effect palliative care for their loved ones had on caregivers. They discovered family members who were caring for a patient who receive palliative care reported lower depression symptoms, as well as less anxiety compared with caregivers of patients assigned to usual oncology care.
Planning for the End of Life
We’ve discussed the importance of planning ahead in ensuring your end-of-life wishes are honored. Selecting hospice care early on lessens the difficulty and stress of making an important decision at a time of crisis. It can make a critical difference in how a patient comes to terms with dying, and can give families the time they need to prepare themselves for the loss of a loved one. It also means there is time for important discussions about advance directives and other healthcare decisions, while the patient is still able to speak on his or her behalf and make their wishes known.
Paying for Hospice Care
Hospice care is covered under Medicare Part A (Hospital Insurance). Patients who are eligible for Medicare Part A can receive hospice care once the doctor or hospice medical director certifies that the patient is terminally ill and probably has less than six months to live. Patients must sign a statement choosing hospice care instead of standard Medicare. Medicare will still pay for covered benefits for any health problems that are not related to the terminal illness.
A Lack of Understanding in the Medical Community
Sadly, many healthcare providers are not trained in palliative care and, therefore, may not discuss it with their patients. Therefore, patients often need to be the one to bring the topic to the table. Both patients and caregivers should be prepared to discuss palliative care with the patient’s physicians.