American hospice service started with the Connecticut Hospice in March 1974. Today, there are over 2,884 Medicare-certified hospices, and an additional 200 volunteer hospices in the U.S., with as many as 1.5 million Americans seeking hospice treatment in recent years. As a program designed to facilitate “palliative” care for terminally ill patients and their families—many people wonder, what then is the difference between hospice and palliative care, or are they one in the same? While palliative care addresses patients with life-threatening illnesses, anyone—regardless of life expectancy—can receive this type of care. Hospice, meanwhile, provides for patients who can no longer benefit from regular medical treatment, per a doctor’s determination, and are in the last stages of a terminal illness. Hospice and palliative care share the philosophy of maintaining and managing the patient’s quality of life.
Palliative care programs generally address the physical, psychosocial, and spiritual needs and expectations of a patient with a life-threatening illness, at any time during that illness, even if life expectancy extends to years. Palliative care does not preclude aggressive treatment of an illness, and provides comfort to patients and their loved ones. Patients receive palliative care from a team of doctors, nurses, social workers and clergy in their home or a hospital, but also in nursing or assisted living facilities. Hospitals, hospices, skilled nursing facilities and health care clinics provide these services, which may include a monthly visit to a doctor, or weekly home visits from a social worker or nurse to help manage pain and symptoms.
The goal of hospice care is to keep pain and suffering of a person with a terminal diagnosis to a minimum, and not to cure the illness. Provided in the patient’s home or in hospice centers, hospitals, skilled nursing homes and other long-term care facilities, hospice is based on the belief that every person has the right to die pain-free and with dignity, and with family and friends nearby. Like palliative care, a hospice team is comprised of doctors, nurses, caregivers, social workers and trained volunteers who manage the patient’s pain and symptoms; assist with the emotional and spiritual aspects of dying; provide needed medications and supplies; coach the family on how to care for the patient; and, provide bereavement counseling to surviving loved ones.
While Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations provide hospice coverage, Medicare or Medicaid does not currently cover palliative care. Some private insurance companies cover the costs of palliative care, but it is important for you to ask the palliative care provider how or if the services will be covered and what, if any, costs you will be asked to pay.