Palliative care and hospice care might seem to be the same thing. But to those who deliver health care under either umbrella, there’s a difference.
“All hospice care is palliative care, but not all palliative care is hospice care,” said Brenda Jaszczyszyn, director of Education and Quality at Emmanuel Hospice in Grand Rapids. “And there are other distinct differences.”
Hospice focuses on caring — not curing — patients who, in general, have a life expectancy of six months or less. Hospice care is usually delivered wherever a person calls home. It’s a philosophy built around the key concept that a person at the end of life has physical, psychologi- cal, social and spiritual aspects of suffering. It leans on a team of caregivers who provide access to an array of ser- vices — everything from drug regimens to music therapy and much more, depending on the hospice organization.
Palliative care provides treatment for patients facing serious and life-threatening illnesses. But unlike hospice care, palliative care can be accessed at any point during an illness and alongside curative treatment.
While hospice is covered by Medicare, Medicaid, most private insurance plans, HMOs and other managed care organizations, palliative care is not as widely covered by all insurance plans. Also, palliative care is generally dependent on a referral from a primary care physician and is generally conducted in a clinic or in-patient setting.
Jaszczyszyn has worked 18 years in hospice and has seen the benefits of palliative care close up with her own mother and mother-in-law.
Palliative care was administered to help her mother deal with the onset of cancer and pain that attended her condition for about a year. When her pain was brought under control, they stepped back from her active care, but are just a phone call away if they are needed again. When the time comes for hospice care, the family is ready.
Her mother-in-law found respite in palliative care when she finally eschewed pills for her hip pain and found relief in the surgical implantation of a neurostimulator that allowed her to walk her dog several miles a day, even as she progressed through her 80s.
Palliative care is gaining ground, said Jaszczyszyn, noting that in 2000, just 632 hospitals offered this type of care. As of 2015, more than 1,600 hospitals had palliative care as part of their offerings. Many hospitals in Michigan offer palliative care, and some communities have added out-patient services, as well.
“With palliative care,” she said, “you can get care any- time during the disease trajectory. It helps you to manage so many factors and, in some cases, leads to a longer life expectancy.”