What is Hospice care all about, really?

Palliative care is a specialized team approach to helping a patient to cope with the debilitating symptoms of certain serious complicated illnesses such as parkinsons Disease, heart failure, kidney failure, or COPD. The patient is receiving curative treatment and emergency room care during acute episodes of illness, and can receive dietary support, pain management, grief counselling, massage and other forms of care from the palliative care team of health professionals. This can greatly improve the patient’s ability to cope with the symptoms of their illness.

Palliative care services are generally provided at the bedside in a hospital or skilled care facility (nursing home or rehabilitation center) and can still be covered by certain health insurance programs such as Medicare. That would include room and board under Medicare part A . Of course each insurance plan has to be scrutinized to verify the coverage.



Hospice care is sometimes referred to as “palliative care,” but is really something different. It is an alternative to curative treatment,  for a patient who no longer wants medical treatment, and is often provided in the home . When a person with terminal illness feels that they have exhausted the benefits of ongoing aggressive treatment, they may decide that it is time to forego further “treatment” and focus instead on remaining as comfortable as possible for as much time as they have left.. The patient or their health care proxy decision-maker opts out of further curative treatment. The patient then will receive palliative care and pain control. The patient may be at home, in a health care facility or in a hospice facility. Medicare does not pay the room and board charges for hospice care. Although the point of decision may be more apparent for certain patients whose cancer treatment is no longer productive, there can also come a time when further treatment will be declined by a patient with stage four heart failure, or who has advanced alzheimers dementia  and other progressively degenerative clinical conditions such as congestive heart failure or kidney failure. http://www.njhospice.org/

It is very important that all patients sign a health care proxy (to designate their medical decision-maker should they become incapable of making decisions), and if they have particular wishes regarding the use or non-use of lifesaving treatment,  an advance directive. When in the hospital, they or the health care proxy needs to make their wishes known so that the treatment doesn’t run away with the patient at a time that the patient or their proxy prefers to forego treatment.. In New Jersey, physicians must discuss these issues with the patient and complete a form called POLST setting down the patient’s wishes. http://www.nj.gov/health/advancedirective/polst.shtml

Elder Care requires a team approach. The palliative care team can greatly enhance the family’s experience at the end of life.

 For legal advice on preparation and implementation of health care directives, powers of attorney and elder care planning, call … 732-382-6070

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