What is the difference between hospice and palliative care?
Palliative care treats symptoms and stress at any stage of a serious illness, alongside treatment meant to cure or control it; hospice is palliative care for the final phase, when a doctor expects six months or less and curative treatment stops.
| Hospice | Palliative care | |
|---|---|---|
| When | Prognosis of six months or less | Any stage of serious illness |
| Curative treatment | Stops for the terminal illness | Continues |
| It isn't | Giving up -- people can leave hospice | Only for the end of life |
| Paid by | Medicare hospice benefit | Regular Medicare Part B and insurance |
Where is hospice provided in West Michigan?
Wherever the person lives: at home, in an adult foster care home, a home for the aged or a nursing home. CMS lists 14 Medicare-certified hospices with offices in our five counties.
The hospice directory lists each with ownership and certification year.
Does Medicare hospice pay for room and board?
No. Medicare's hospice benefit covers the hospice team, medications and equipment related to the terminal illness, but not room and board in a facility; Medicaid may cover room and board for eligible nursing home residents.
Ask a residential home whether it already works with a particular hospice; most do with several.
When should a family ask about palliative care?
Early -- at diagnosis of a serious illness such as heart failure, COPD, advanced cancer or dementia -- because palliative care works best before a crisis.
Ask your parent's doctor for a palliative care referral; the major West Michigan hospital systems offer palliative teams, and some hospices run palliative programs too.
What are the four levels of hospice care?
Medicare defines routine home care, continuous home care during a crisis, inpatient respite care to give caregivers a break, and general inpatient care for symptoms that cannot be managed at home.
Most hospice days are routine home care, delivered wherever the person lives. Ask any hospice where its inpatient care happens.
How does hospice work in an AFC home or home for the aged?
The hospice team visits the resident in the home and works with its staff; the home keeps providing daily care and room and board, which the family or other payers cover.
Ask the home before move-in whether residents can stay through the end of life with hospice support; most can, but care needs that exceed the home's license can still require a move.
Who pays for palliative care?
Palliative care visits are billed like other medical care -- Medicare Part B, Medicaid or private insurance -- so copays and deductibles apply.
