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Hospice or Palliative Care?

It an attempt to discuss the differences between Hospice and Palliative Care I've gathered some information.

There are differences in these two programs - some are slight and some are not-so-slight. If you or a loved one is trying to determine which one is right for you do your research. Read everything you can on each program. Talk to the people involved, like a Hospice Counselor and Palliative Care Director (which will be your Physician). Only you can make the decision. The following was gathered from several trusted sites along with a bit of my own input. I am not an expert - just experienced in long term care, death and dying and a bit in both Programs.

Most of us have heard of Hospice care. We have a general idea of their services. What many don't understand is that Hospice does provides Palliative care.  Palliative care is both a method of administering “comfort care" and an administered system of Palliative care which is offered most prevalently by hospitals and long term care facilities.

Hospice programs far out number Palliative care programs. Hospice Care is generally provided in a home - though is some cases there are "Hospice Houses" for short term stays - or on rare occasions within a hospital, also for short term stays. Hospice in an all inclusive program including services and billing. All your needs are to be met through the Hospice. Your physician continues to monitor you and order needed medications. A Staff consisting usually of a RN, a Personal Care Giver and a Spiritual Counselor provide home visits - usually several times per week - more or less in needed or indicated. You may chose to end Hospice at any time.

Many hospice programs are covered under Medicare.

Hospice programs concentrate on comfort rather than aggressive disease abatement. Patients are terminal and most have a short amount of time left on Earth. Most Hospice patients can achieve a level of comfort that allows them to concentrate on the emotional and practical issues of dying.

Palliative Care is not an umbrella Program. Services are independent from one another as is billing. Unlike Hospice Palliative Care may be instituted at any stage of an illness. One does not necessarily need to be terminal - but you must have a Chronic, disabling condition. Rather one is terminal or chronic - life-prolonging therapies and measures can and often are taken. How much or how little life-prolonging measures are instituted is left up to the individual to determine. Your physician must order each service you may need, including medications, any therapies (including oxygen), home health care, etc. He/She is the sole director. You make the calls for services through him. This may work especially well if one has a good, long term relationship with their physician.

Palliative Care cost(s) are paid depending upon your insurance's (including Medicare if applicable) coverage of out-patient and hospitalization services.

There are some Hospice programs that will provide life-prolonging treatments, and there are some Palliative care programs that concentrate mostly on end-of-life care.

There is much more to this decision of Hospice or Palliative Care. My father had one and my mother another. Both programs were appropriate at the time for their situations.

I and my sibling feel that Hospice provided much better care and comfort than did the Palliative Care. They readied our beloved parent for their final journey, with love and understanding - and provided the family with the same. There was nothing done without our approval (based on our parent's wishes) - we called the shots. After we lost our loved one they were there to offer comfort and love. Our parent appeared comfortable in their final days.

Our other parent had Palliative Care in a hospital - on a busy medical unit. That parent and of course we fought with several members of the nursing staff to give medications and care as directed. Needs were slow to be meant if at all. We provided most of the care. Remember much of hospital staff are busy caring for the living - less interested in caring for the dying. There was/is a big difference between staff in each program. Most hospital staff were not "schooled" in Palliative Care and End of Life issues. We did have a few that were supportive. The physician was wonderful. He went above and beyond and followed our parent's wishes to the T. He was at the hospital every time we turned our heads - which did provide better care and support. Your physician will be very, very important in Palliative Care.

Read, Read, Read! Make an educated choice that is best for you and/or your loved one. Don't forget that you can change your mind at any point. If you decide on Hospice and later feel it's the wrong decision you can always leave the program and the same is true for Palliative Care.

Bless you as you search. No decision is wrong when it's an educated one made with love. We're here if you have questions - or if you're just looking for support - or want to vent.

Best Wishes,
~Tuck
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