Hospice Care explained

When a person receives a terminal diagnosis, they can choose to receive hospice care.

Hospice is medical care designed for the end of someone’s life. The purpose of hospice is to improve the quality of life that’s left. Hospice provides pain and other symptom relief, as well as emotional, psychosocial, and spiritual help to support you and your family.

There are four types, or levels, of hospice care:

• Routine home care. Routine home care is the standard level of most hospice care. When you receive routine home care, your hospice team will come to where you live to provide nursing, therapeutic, spiritual, and other care. Your hospice team will coordinate this schedule with you and your family.
• Continuous home care. If you’re having a medical emergency or need around-the-clock care, your hospice team will provide continuous home care. For example, if you were experiencing severe pain that wasn’t relieved by your current medications, a nurse might stay with you for an extended period of time to resolve the issue.
• General inpatient care. Some symptoms can’t be managed at your home. In this case, the hospice physician might recommend an inpatient hospital or inpatient hospice stay. At your inpatient stay, your symptoms will be addressed so that you can return to receiving routine hospice care at home.
• Respite care. Respite care is short-term care that provides a break to family caregivers. When you receive respite care, you’ll stay at an inpatient hospice, a skilled nursing facility, or a hospital for a set period of time. Respite care can help family members who need to travel, are having their own health concerns, or simply need a break from full-time caregiving.

The hospice care level won’t affect the quality of the care you receive. Your setting might change temporarily, but your plan of care won’t. All hospice providers that are certified by Medicare are required to provide all four care levels.

The goal of hospice care is to help a person who has a terminal diagnosis have the highest possible quality of life. Instead of performing tests and procedures, hospice care provides relief from pain or other symptoms, as well as emotional and spiritual support.

Once you enter hospice care, you’ll be asked to appoint a primary caregiver — typically a family member or close friend. This person will work closely with your care team to communicate your needs and develop a customized plan.

Your care team will consist of healthcare professionals including:

• doctors
• nurses
• nursing assistants
• physical therapists
• occupational therapists
• speech therapists
• social workers
• dietitians
• medical chaplains

The exact services you receive will depend on your condition, needs, and preferences, but will often include:

• medication for pain relief
• medication to manage other symptoms
• mobility aids such as wheelchairs and walkers
• medical supplies you need for care at home
• physical, occupational, and speech therapy as needed
• meal planning and nutrition services
• treatments to relieve symptoms and pain
• grief counseling and emotional support for you and your family
• care coordination
• assistance with bathing, eating, and other activities of daily living

Generally, you’ll stay where you currently live to receive hospice care. Your care team members will come to you as needed throughout the week and will be available 24/7 if you have additional needs. Your hospice plan will be built around you and your needs.

Your family will be part of the process and will also receive support. Your team will monitor you and adjust your care as your illness progresses.

It’s easy to get the terms hospice care and palliative care confused, but they refer to two different types of care.

Both hospice and palliative care are for people with diagnoses of serious illnesses. However, you can use palliative care throughout treatment of a condition, not just at the end of life.

Palliative care can start the moment you get a diagnosis. Palliative care can provide support to you and your family and can help you make decisions about the care you receive.

The primary difference between palliative and hospice care is that hospice care is only available at the end of your life. A doctor needs to certify you have 6 months or fewer to live. You can receive palliative care at any time as long as you have a diagnosis of a serious and chronic condition.

Palliative care can help you manage your pain and other symptoms, but you can still receive treatments for your condition during palliative care. Most palliative care is done outpatient, although some palliative care providers might offer home care as well. Additionally, you can receive palliative care for as long you need it and your insurance will cover it.

The main difference between palliative and hospice care is when they’re available.

Palliative care is available from the moment of diagnosis. In other words, it doesn’t depend on the stage of your illness or whether you’re still receiving curative or life-prolonging treatments.

The table below explains some key differences between palliative and hospice care.