Hospice and Palliative Care

Dame Cicely Saunders (founder of the first modern hospice in London in 1968) summed up the hospice philosophy best when she told her patients:“You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.” Hospice care is a model for quality compassionate care for people facing a life-limiting illness. It is a team approach to expert medical care, pain management, and emotional and spiritual support tailored to the patient’s needs and wishes.

Who is eligible for hospice care?

When the goal of treatment begins to shift from cure to providing comfort, it may be time to consider hospice for persons facing terminal cancer: end-stage heart, lung, kidney or liver disease; severe dementia; severe Parkinson’s disease; or stroke. A physician must certify that the person is in the last stages of a terminal illness.

Where is hospice care provided?

Most hospice care is provided in a person’s own home. Hospitals, nursing homes, assisted living, care or foster homes are other possible settings.

What services are covered under hospice care?

• Nursing: pain and symptom management
• Personal care/home health aide
• Social services
• Spiritual counseling
• Volunteers
• Respite care
• Bereavement support

Who pays for hospice?

Medicare, Medicaid and all medical insurances offer hospice benefit. Durable medical equipment and medications related to the terminal diagnosis are covered. Little or no co-payment is required.

What is palliative care?

According to the World Health Organization (WHO), palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and assessment and treatment of pain and other problems, physical, psychosocial and spiritual.

How is hospice different from palliative care?

Palliative care is specialized care for persons with life-threatening illness, regardless of life expectancy. Hospice is a type of palliative care that occurs at the very end of a person’s life.

What is supportive or concurrent care?

“Supportive” or “concurrent” care is a type of palliative care that encompasses all the extra care provided in addition to regular medical care by a full team of physicians, nurses, social workers, chaplains, and aides who specialize in caring for people facing serious illness. This means that somebody with a serious illness can have all the benefits of comfort care and still receive life prolonging treatments.

Who pays for Supportive or Concurrent Care?

Hawaii Medical Service Association (HSMA) offers supportive care services for homebound members who have advanced cancer, advanced heart failure or emphysema. University Health Alliance (UHA) offers concurrent care services to persons with any serious illness. HSMA and UHA have partnered with local hospices to offer this innovative program.