News & Events

Northern AZ Hospice explains Palliative care and Hospice care differences

Susan Wall L.C.S.W.

Palliative care, also known as “Comfort Care,” is a philosophy of medical care that seeks to manage the symptoms of people with chronic illnesses. Although there are exceptions, it’s generally understood a chronic illness requiring palliative care is permanent, incurable and eventually terminal. An illness requiring palliative care intervention often consists of a host of symptoms such as pain, swelling, breathing issues, bowel problems, breaches in skin integrity, or depression. A person also may have more than one diagnosis.

The primary difference between palliative care and hospice is that Medicare hospice guidelines state a patient must have a prognosis of six months or less of life expectancy. People in need of palliative care might not have a limited life expectancy. They also may be receiving treatments of a curative nature meant to limit the progression of their disease. People choosing hospice are removing most curative interventions from their treatment and availing themselves strictly of comfort care.

Hospice is a program covered by Medicare and many private insurers. With recent state budget constraints, it is now a non-covered service under the state health program (AHCCCS). Palliative care, in and of itself, is not an official program and is not covered under any insurance agency, including Medicare. Rather, palliative care services are billed as a regular symptom/diagnosis generated service—just like going to the doctor to follow-up on the management of a chronic condition.

Hospice staffs are uniquely qualified to provide palliative care because they understand the process of serious ailments. They know the simplest and easiest way to manage symptoms—a refreshing experience for many people who have had years of expensive medications and complicated treatment protocols. With compassion, hospice staff helps people regain control of their lives within the constraints of their illness and live their lives to the fullest extent possible.

A study published in the New England Journal of Medicine, Aug. 18, 2010, described the benefits of palliative care on a group of 151 patients diagnosed with serious lung cancer. The study found patients receiving the same care as their control group peers, but with the addition of palliative care, lived longer, had lower rates of depression, and had an improved sense of their quality of life. 
Hospice staffs see similar results to their interventions. During the first few days, patients admitted to hospice find their pain and symptoms become managed. They begin to feel more comfortable, and are able to adjust their daily activities to better reflect their body’s functioning. In some cases they begin to stabilize. After a few weeks, in some hospice cases, it becomes clear a person is no longer imminently dying, but rather, is living comfortably. In this case, the person is released from hospice, but under the same, effective symptom-management protocol. The patient is welcome to return to hospice when it’s appropriate again. This philosophy is more realistic and fair to patients and their families, is more cost-effective to insurance companies, and is mandated under Medicare guidelines.

Northern Arizona Hospice offers palliative care consultations to professionals and patients desiring information on managing specific chronic health issues. If this approach sounds right for you, call the office at Northern Arizona Hospice. Consultations require the approval of a primary care doctor. Persons who are appropriate for hospice care will be referred to Northern Arizona Hospice, or if not hospice then to Northern Arizona Homecare if they meet the criteria for that service.  
Palliative care often is a misunderstood concept of care because it is new as a medical specialty. With improved community and professional education, it is becoming another valuable treatment option for chronically ill people.

Susan Wall, LCSW, has been a medical social worker with Northern Arizona Hospice/Homecare for 13 years. If you belong to an organization that would like to have a Hospice/Homecare consultant offer a presentation to your group, please call 639-6672.