Providing Care for People With Life-Threatening Diseases
Palliative Care is actively caring for people with life-threatening diseases. By concentrating on the patient and family as a unit, we are better able to help manage distressing physical and emotional symptoms. This focus helps maximize quality of life and assists patients in living out their days in such a way they can reach their goals with the support of their family.
When to Seek Palliative Care
Palliative care is appropriate whenever there is an underlying serious or life-threatening illness and:
- There is a distressing physical symptom, such as pain, nausea or loss of appetite.
- There is a difficult decision to be made concerning the most appropriate level of life-sustaining care.
- Assistance is required by patients and/or families in coordinating end-of-life care services.
Referral to palliative care can be made by physicians or directly from patients and their families.
Patient and Family Care
Inpatient consultation and outpatient services are offered to provide assistance in the following areas:
- Pain and symptom control
- Medical decision-making
- Coordination of care
- Relationships with hospices and home health agencies
Because we understand the difficulties and complexities of making and arranging for such decisions, we have liaison relationships with the entire community, including hospice and home care agencies, so we can provide uninterrupted care between the hospital and home. Our Palliative Care Program’s staff helps coordinate discharge services with the appropriate hospice or home care program nearest to the patient’s place of residence, and then we go on to ensure the full support of everyone during the transition.
The Difference Between Palliative Care and Hospice Care
The recent introduction of the term ‘palliative care’ has been confusing to health professionals and patients alike. Although the philosophies of care are identical (focus on quality of life, symptom control, patient and family as the unit of care, interdisciplinary care), there are major differences of reimbursement, eligibility for services and care settings. Still, we feel it is important to recognize hospice and palliative care as complementary, rather than competing, services, and that each is essential to seriously ill and dying patients within our current system of health care financing.
Hospice care is both a philosophy and a method of health care financing for dying patients and their families. Medicare Hospice Benefit provides this service (as does the Wisconsin Medicaid program and many private insurers) for patients who elect for the hospice care and have a physician-certified prognosis of less than six months to live. Reimbursement for hospice services under Medicare is on a per diem basis, payable from Medicare to a certified hospice agency.
Palliative care is a philosophy regarding the delivery of care to the seriously ill and dying, and it is emerging as a major new focus of medical and nursing practice. Palliative care evolved in the 1990s to:
- Fill in the gaps; to meet the needs of dying patients and families who don’t qualify for hospice care or who are not ready to accept real or perceived limitations of aggressive or technological care imposed by the hospice reimbursement system
- Extend the hospice philosophy into the acute care and long-term care setting
- Work towards a seamless and gradual transition of care from curative, aggressive approaches to more palliative measures.
Prognosis, types of treatments offered or the need for a hospice insurance benefit do not limit palliative care services.