Palliative care is whole-person care that relieves symptoms of a disease or disorder, whether or not it can be cured.  Hospice is a specific type of palliative care for people who likely have 6 months or less to live. In other words, hospice care is always palliative, but not all palliative care is hospice care. Hospice is comfort care without curative intent; the patient no longer has curative options or has chosen not to pursue treatment because the side effects outweigh the benefits. Palliative care is comfort care with or without curative intent.

Palliative care is begun at the discretion of the physician and patient at any time, at any stage of illness, terminal or not. 

• Your prognosis must be greater than 6 months 
• You are not identified by your doctor as terminally ill 
• You or your family is not emotionally ready for hospice 
• You want aggressive oriented treatment 

Palliative care is provided by an interdisciplinary team that may include a doctor who specializes in palliative medicine, a nurse, pharmacist, social worker, dietitian, and volunteers. They address physical, emotional and spiritual pain, including such common worries as loss of independence, the well-being of the family and feeling like a burden.

Your other doctors focus on your general health or treating your disease or condition. Palliative doctors concentrate on preventing and alleviating suffering, improving your quality of life, and helping you and your loved ones cope with the stress and burden of your illness.

Yes. Palliative doctors have special training and expertise in pain management and symptom control, and specialize in helping patients and their families cope with the many burdens of a serious illness, from the side effects of a medical treatment to caregiver stress to fears about the future. Palliative doctors can assist you with difficult medical decisions, helping you weigh the pros and cons of various treatments.

Absolutely. Your palliative doctor coordinates care with your other doctors and helps you navigate the often-complex healthcare system. 

No. Insurers and Medicaid agencies will provide coverage for hospice care if your doctors determine you likely have 6 months (in some cases a year) or less to live if your illness follows its normal course. However, it is your own choice to enter or leave hospice care. If your illness improves or you wish to seek curative treatment, you may leave hospice care, returning if and when you choose to.

Not at all. The goal of palliative care is to make you comfortable and help you achieve the best possible quality of life. You can have palliative care while you are undergoing treatments that may cure or reverse the effects of your illness. In fact, palliative care can help you cope with aggressive treatments by getting your pain and symptoms under control to help you fight the disease. 

Palliative care can be provided at a hospital, a nursing home, an assisted-living facility, or at home. There are a number of ways to find a doctor who specializes in palliative medicine, including asking your personal doctor to refer you to a palliative doctor or asking your local hospital if they have a palliative specialist. 

Palliative doctors are concerned about you as a whole person—not just the part of you that is sick. They understand that people with serious illnesses can be frightened and unsure of themselves when making medical decisions. They also understand that there is not always one right or wrong answer and that your needs and wishes may change over time. Palliative doctors consider all of this when they help you develop your  treatment plan.

Many private insurance companies and health maintenance organizations (HMOs) offer palliative care and hospice benefits. Medicare (mostly for people 65 and older) offers  hospice benefits, and the extra Medicare plan (Part B) offers some palliative care benefits. Medicaid coverage of hospice and palliative care for people of limited incomes varies by state.

Your case manager will work with you upon admission to assess your needs and help with obtaining any necessary medical equipment. Your needs will be reassessed throughout the continuum of care. 

Coordinated patient care is composed of a variety of disciplines working together with the family to provide care in the home, or wherever the patient calls home. The team includes, but is not limited to, the following disciplines:

• The medical director serves as consultant to staff and referring physicians, attends team meetings and oversees the medical aspects of the hospice program.
• The registered nurse (RN) is the team leader and performs the initial assessment. The RN monitors the patient’s condition, reporting changes and problems to the physician. After the initial assessment, a licensed vocational nurse (LVN) may perform many of the same tasks as the RN.
• The medical social worker (MSW) provides psychosocial support for the patient, the family and the hospice staff. The MSW also assists with community referrals and financial concerns.
• The home health aide provides personal care of the patient, such as bathing, shampooing the hair or changing the linens.
• Chaplains are an important part of the hospice team and provide emotional and spiritual care support for the patients and their families. Chaplains, along with the bereavement team, can be an excellent resource for helping with funeral planning or a DVD life tribute.
• Hospice volunteers help patients and families, just as a friend might, by assisting with household tasks, running errands, telephoning or visiting. They are a Medicare-mandated member of the team and invaluable to the care of each and every hospice patient.

No, hospice originally dates back to medieval times when it was a place for weary travelers to find shelter and temporary respite. The word “hospice” comes from the Latin words “hospes” meaning host and “hospitium” meaning hospitality. Today, hospice is recognized as a program of palliative (comfort rather than curative) care and support designed to meet the unique needs of patients and families facing limited life expectancy. Services are provided through a medically directed team of professionals.