Improving Comfort and Quality of Life During Serious Illness

Palliative care and hospice are terms that describe care that aims to improve a person’s comfort and quality of life during serious illness. Both use a team approach to focus on quality of life and comfort care, including the active management of pain and other symptoms, as well as the psychological, social and spiritual issues often experienced with illness.

The difference is that hospice is a specialized form of palliative care that focuses on serving and comforting you and your family at the end of your life or as your illness becomes terminal with a goal of comfort, not cure. In contrast, anyone regardless of life expectancy can receive palliative care, which can be provided alongside of aggressive life-prolonging and curative treatment. Receiving palliative care does not mean you are dying, only that you may need additional help with the symptoms of your illness, such as pain, difficulty breathing, nausea, or other issues.

Hospice

Hospice provides care, comfort and support for persons with life limiting conditions as well as their family. Curative care is generally not sought while receiving hospice, but simultaneous hospice and curative treatment for people under the age of 21 is available under Medicaid.

Hospice is a team approach to person-centered care that includes: physicians; nurses; home care aides; social workers; clergy or other counselors; and trained volunteers. They work together to address the dying person’s physical, emotional, social and spiritual needs.

Hospice care is usually given in an individual’s home, but it also may be provided at an inpatient facility such as a nursing facility or certified hospital. The treatment plan and services offered may vary dependent on the individual’s terminal illness, related conditions, symptoms and wishes.

Eligibility

Hospice is generally for individuals with a life expectancy of 6 months or less. Hospice care may still be available if the individual lives longer than 6 months with a hospice medical director or other doctor re-certification of the patient.

Services

Hospice care addresses the physical, psychological, social, and spiritual needs of patients with a terminal illness. The specific type of care and services provided may differ depending on the needs and preferences of the individual, but generally include the following:

  • Managing pain and symptoms
  • Administration of medicine, supplies and equipment
  • Speech and physical therapy if needed
  • Short-term inpatient care
  • Spiritual services and
  • Bereavement care and counseling to family and friends

Learn More: Your physician or other care provider is the best place to start to find an appropriate hospice provider for your needs. You may also go here to find a hospice provider near you.

Financial Options

Hospice can be covered by the Medicare Hospice Benefit, Medicaid Hospice Benefit, the Veterans Health Administration and most private insurers. If you do not have coverage through Medicare, Medicaid or a private insurance company, hospice will often work with you and your family to ensure needed services can be provided.

Additionally, in Connecticut, Community First Choice participants are allowed to use Medicaid funds as they deem to best meets their needs and may choose to use funds to create a hospice approach and team.

  • Medicare Hospice Benefit: For information on the Medicare Hospice Benefit, go here.
  • Medicaid Hospice Benefit: For information on the Medicaid Hospice Benefit, go here.
  • Veterans Hospice Benefit: For information on the VA Hospice Benefit, go here.
  • Private Insurance: Some treatments and medications may be covered by private insurers. Contact the insurance provider to determine the level of coverage for these services.

Palliative Care

Palliative care is a holistic approach to the treatment of the pain, symptoms, and stress of an illness for someone at any stage of an illness or disease. Unlike hospice care, the diagnosis of a terminal illness or projection of limited life expectancy is not required.

The goal of palliative care is to improve the person’s quality of life through physical, emotional, social, and spiritual support and to support their family as well. Palliative and curative care may be received at the same time.

People can receive palliative care in their home or in outpatient clinics or hospitals. A comprehensive team of doctors, nurses, social workers, volunteers, clergy and other counselors provide the support needed to relieve the physical, emotional, social, and spiritual difficulties symptomatic of the illness or disease.

Eligibility

People of any age and at any stage of a serious illness or disease may be able to receive palliative care. A diagnosis of a terminal illness or projected life expectancy is not required. An individual can continue to receive curative care at the same time.

Services

The specific type of care and services offered may vary dependent on the needs and wishes of the individual and the team providing the treatment. Generally, palliative care helps with a wide range of issues: pain; depression; anxiety; fatigue; shortness of breath; constipation; nausea; loss of appetite; and difficulty sleeping.

The team providing palliative care also aims to educate the individual on their treatment options and improve their ability to tolerate any medical treatments.

Learn More: Your physician or other care provider is the best place to start to arrange appropriate palliative care for your needs. You may also visit the 2-1-1 website for a list of palliative care services, supports and providers near you.

Financial Options

Some treatments and medications provided may be covered by Medicare, Medicaid and/or private insurance companies.

  • Medicare:
    Medicare does not use the term palliative care, so any coverage would be provided by standard Medicare Part B benefits. Medicare Part B may cover some treatments that provide palliative care, including visits from doctors, nurse practitioners, and social workers. Services that provide comfort may be covered if your doctor orders them as medically necessary.
  • Medicaid:
    Medicaid does not use the term palliative care, so any coverage would be provided by the standard Medicaid benefit. Medicaid may cover some palliative care treatments including visits from doctors. Services that provide comfort may be covered if your doctor orders them as medically necessary.
  • Private Insurance:
    Some treatments and medications may be covered by private insurers. Contact the insurance provider to determine the level of coverage for these services.

Learn More: Download the National Institute of Nursing Research’s pamphlet on Palliative Care for more information.