End-of-Life Care

What Is Palliative Care?

Palliative care is for anyone with a serious illness, regardless of whether they continue pursuing curative treatment.

It consists of interdisciplinary healthcare designed for people with serious illnesses. It includes healthcare professionals from different specialties who collaborate to keep patients comfortable.

Palliative care can be provided in a hospital, nursing home, assisted living, or home setting. The team provides medical, social, and psychological support to the patient and their family. Unlike hospice care, palliative care does not require the patient or family to stop treatment of the disease.

Who Provides Palliative Care?

The palliative care team does not replace the patient’s regular medical team. The team is specially trained to help address symptom management and the stress of the illness on both the patient and family.

The palliative care team will work alongside the patient’s medical specialists and primary care provider to improve the quality of life while the patient and family navigate chronic illness. The palliative care team can address symptoms such as pain, anxiety, or shortness of breath and can provide social and emotional support to the family. They can also help guide the patient and their family through the next steps of the patient’s illness and provide information on what the patient or family may be able to expect next.

Who Provides End-of-Life Care?

If an illness is terminal and the patient has reached a point where curative measures are no longer effective, it may be appropriate to consider end-of-life care.

Hospice care is a common option for end-of-life care. Hospice care is for people who, if their disease follows its normal course, are estimated to have six months or less to live and who are no longer seeking curative treatment.

Hospice can be provided in nearly any setting, including the hospital, home, or nursing home.

Hospice care focuses on symptom control and support of the patient and family, and most curative treatment is stopped. In specific cases, such as radiation in cancer patients, treatment may still be continued, but the goal of care changes. The treatments are focused on symptom control rather than cure of disease.

Patients who do not die within six months are not necessarily removed from hospice, but if a patient is not declining or their prognosis changes, they may be graduated from hospice. At this point, they may be able to transition to palliative care. In some cases, the palliative care team can provide end-of-life and hospice care as well as care for the family after the death.

Who Is End-of-Life and Palliative Care For?

Some of the diseases that may qualify for palliative care include (but are not limited to):

• Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease)
• Alzheimer’s disease and dementia
• Cancer
• COPD
• Covid-19
• Heart failure
• Eosinophil Associated Disease (EAD)
• Huntington’s disease
• Kidney disease
• HIV/AIDS
• Liver disease
• Parkinson’s disease
• Pulmonary Fibrosis
• Sickle Cell Anemia
• Stroke

When Does End-of-Life Care Begin?

The timing for end-of-life care can vary depending on the patient’s and their family’s needs. Palliative care can be started at any time for a serious diagnosis or even a terminal diagnosis that isn’t yet hospice-appropriate. In many cases, the sooner a serious condition is diagnosed, the sooner the patient and their family can get the support they need for the journey ahead of them.

Hospice care is recommended when a patient is diagnosed with a six-month or less life expectancy and is no longer pursuing curative treatment. The healthcare team may recommend hospice care, or, in some cases, a family may self-refer for services.

How Do I Find Out About End-Of-Life Care Services In My Area?

There are many options to help people find end-of-life resources in their area.

The first place to start is with your healthcare team. Many doctors, especially those treating patients with serious and terminal conditions, know the resources available in their communities.

Internet searches for palliative care or hospice may also provide the names of organizations you can call. Most hospitals and some healthcare clinics have a social worker or case manager who can provide additional resources.

The National Hospice and Palliative Care Organization also has resources available for patients and their families.

How End-of-Life and Palliative Care Can Help You

End-of-life and palliative care teams provide resources if you or someone you love has been diagnosed with a serious or terminal illness. The team is there to offer symptom relief to improve comfort and quality of life. They will also help with the psychological and social ramifications of the disease, including helping you understand what to expect from treatment or disease progression.

The palliative care team may help:

• Coordinate getting your loved one additional equipment, home health aides, and respite care
• Guide end-of-life planning, such as providing information about how to obtain advance directives and how to choose a senior living facility for your loved one as their condition progresses
• Explain the costs of care and what resources are available to help cover these

Studies have shown that palliative care is associated with a longer life expectancy, less depression and anxiety, and improved patient and family satisfaction.

Cost of Palliative Care

Palliative care services may be covered by insurance. However, the amount of coverage, copays, and deductibles may vary from plan to plan, so talking with your insurance company may better help you understand the costs associated with care.

Hospice care is generally covered if you have Medicare Part A and meet the program’s admission criteria. Hospice will generally cover most, if not all, of the costs associated with hospice care.

Taking the Next Steps

Palliative and hospice teams offer compassionate care and support to patients and their families as they navigate the emotional landscape of a serious or terminal illness. Having them as part of the healthcare team can be an invaluable resource as you and your family navigate this difficult time.