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Hospice and Palliative Care
 

Curative vs. Palliative Care

 
Curative Care is treatment that is intended to promote recovery from a disease or condition.

 

The goal of Palliative Care, on the other hand, is not to cure, but rather to provide relief and improve the patient’s quality of life.

Hospice provides end-of-life, palliative care and support for the patient who suffers from an incurable disease or who chooses not to undergo curative treatment. Hospice also provides care and support to the patient’s family members. 

 

The goals of hospice include improving quality of life, maintaining dignity, controlling pain, and providing comfort through counseling for the patient and the family. Hospice uses a holistic approach to medical treatment that addresses physical, mental, social, and emotional needs.

 

For more information about palliative care, visit the Oklahoma Palliative Care Resource Center's website at http://okpalliative.nursing.ouhsc.edu/.

 

Who Is Eligible for Hospice?  
 
In general, anyone who has a life expectancy of six months or less is eligible for hospice. The patient’s doctor and the medical director of the hospice organization must certify that the patient is eligible for hospice. As long as a doctor continues to certify that the patient’s life expectancy is six months or less, hospice care can continue even if the patient lives longer than expected.
 
 
What Services Does Hospice Provide?  
 

Types of Services
 
Home health care includes services to maintain a safe and sanitary environment for the patient, such as assistance with bathing, medication, and light cleaning.

 

Bereavement counselors help patients and family members with each step of the grieving process through one-on-one counseling, group counseling, or a coordination of other services. 

 

Respite care provides time off for caregivers to help reduce stress and prevent burnout. Respite care can be provided through in-home care or through impatient care at a nursing home or hospital.

Federal law requires Medicare-certified hospices to provide the following services:

  • nursing and physician services available 24-hours
  • physical therapy, occupational therapy, speech therapy, and dietary counseling
  • medical supplies
  • prescription drugs
  • short-term inpatient care for pain control, symptom management, or respite care
  • home health care
  • bereavement counseling for patients and for family members
Some hospice care providers offer additional services, including:
  • daily visitation by hospice staff or volunteers
  • religious services
  • help with making funeral arrangements
  • in-facility patient care
  • group counseling
How Is Hospice Paid For?  
 

Medicare Eligibility

 
If a patient is at least 65 years old, he or she is most likely eligible for Medicare Part A. Patients who are under 65 but have been disabled for at least 24 months may also be eligible for Medicare benefits, including hospice.
Medicare
 

Medicare pays for hospice care for patients who meet the following requirements:

  • The patient is eligible for Medicare Part A
  • The patient’s primary care physician and a hospice medical director certify that the patient is terminally ill and is expected to live no more than six months if the disease or condition runs its normal course
  • The patient signs a statement choosing hospice and waives other Medicare-covered benefits, including curative treatment for the underlying disease or condition
  • The hospice is a Medicare-approved provider
 
 
Other Payment Options
 
If a patient is not eligible for Medicare, his or her private health insurance may cover the costs of hospice.
 
If a patient does not have hospice coverage either through Medicare or a private insurance plan, he or she can private pay for hospice benefits. Many hospice providers will provide hospice care to patients regardless of ability to pay.
 
Hospital and hospice staff can provide information about payment options and can assist with applying for benefits.
 
How To Find and Choose a Hospice Provider
 
Each hospice has different strengths and offers different services. Some hospices function in conjunction with nursing homes, hospitals, or religious organizations. Some hospices are for-profit and others are not-for-profit organizations.

 

Several websites offer assistance with finding and choosing a hospice provider, including the Hospice Patients Alliance website, the Hospice Association of America's consumer guide and the National Association of Homecare and Hospice's agency locator.

 
 
 
What To Do If You Have Problems with a Hospice Provider
 
All licensed hospices must comply with state and federal regulations and respect patient and family rights. If you are having a problem with the quality of care provided by a hospice agency, you can:

 

1) Talk to the R.N. case manager

2) Speak with the hospice medical director and manager

3) File a complaint with the state licensing agency (Oklahoma State Department of Health 1-800-658-8898)

 

Patients have the right to change hospice providers. Medicare patients may change providers once every election period. The first election period is 90 days. After the first 90 days, each election period comes in 60-day increments. For those covered by other insurance carriers, the procedure will depend on their specific policies.
 
 
Other Web Resources on Hospice and Palliative Care

Oklahoma Hospice and Palliative Care Association Oklahoma Association for Healthcare Ethics

 

An excellent list of other links to state and national organizations working on end-of-life issues can be found at the Oklahoma Palliative Care Resource Center's Resources webpage.
 
Subpages (4): Hospice Covered Services Hospice Eligibility Hospice Patient Rights Hospice Selection

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