Palliative And Hospice Care Might Not Be What You Think

Most of us have probably known someone who had a chronic illness, or a progressive disease like Alzheimer’s dementia. We may hear that someone “has called in hospice” with the belief that this is a euphemism for “it isn’t long now.” Or perhaps you’ve heard that someone is in palliative care.

As a daily money manager, I interact with a lot of people who work with older adults and several of them work for hospice companies. They have educated me about what these are and I’ve learned that most of what I knew about this topic is wrong, and changed my perspective completely.

I used to think that hospice was just for those last few days of life, and that palliative care and hospice were the same thing. Palliative care and hospice care are not the same thing. Hospice is a type of palliative care, but they are not equivalent.

Hospice Care

Hospice care, contrary to what I used to believe, is not just for that last couple days before death. I have learned that hospice companies can provide care for both the patient and caregivers. As an example, I know of hospice companies that provide support to caregivers and family members for a full year after their loved one dies. Hospice care can also be used for longer periods of time – from six months to more than a year or two. It’s also not just a situation of going on it until death.

Sometimes people improve for a while, even without curative treatments, and go off of hospice for a while if they no longer meet the eligibility. But if the situation changes, hospice can provide services again. This can also be initiated by the patient as well. For example, a cancer patient is on hospice and hears about a new treatment they want to try, They can revoke hospice services to try it, and then later (hopefully much later) they can be reassessed for eligibility when they are ready

There are three requirements to be eligible for hospice: 1) a person with their diagnosis is not expected to live longer than six months; 2) they are no longer using curative treatments; 3) a doctor’s evaluation confirms the first two. Note that #1 says not expected.

As long as no curative treatments are being used, and the person continues to decline, hospice eligibility is reviewed regularly and can be extended again and again until the person finally passes. I know of people who have had dementia (terminal, declining cognition) and have stayed enrolled in hospice for up to 2 years.

Interview Hospice Companies If There Is More Than One In Your Area

Another very important aspect of hospice care is that there are often multiple companies serving a region (particularly in more urban areas), and they each have different services that they offer. I now encourage people to interview multiple hospice providers when they are thinking of using hospice. Part of the reason is that there are many types of situations where hospice is useful, but they aren’t all the same.

Bear in mind that the decision of which hospice to go with is not a one-and-done. If a hospice agency chosen turns out not to be a good fit, people can transfer from one hospice agency to another.

A person on hospice for cancer may need more services around pain management, whereas a person with dementia may benefit more from a service that provides incontinence supplies. Since hospice companies are free to determine what services they will include, it makes sense to find the one that will be the best fit for your situation.

It’s Covered By Medicare

For people 65 and over and enrolled in Medicare, the cost of hospice care is covered by that insurance. Since the services benefit both the caregivers and the individual on hospice, it is a great option for those last six months (or longer).

From learning more about palliative and hospice care my perspective (and I hope yours) has changed. When I hear of someone receiving palliative or hospice care, I feel good knowing that this person has chosen to go through their illness or terminal illness with the best quality of life they can despite their condition. I also know their caregivers are also receiving support.