Hospice or Hospital

What is hospice care?

Hospice care is a specialized form of healthcare that provides comfort and support to people with a life expectancy of six months or less, focusing on enhancing the quality of life rather than curing the illness. It emphasizes palliative care, which manages symptoms like pain and discomfort while addressing the emotional, psychological, and spiritual needs of both the patient and their family. 

An interdisciplinary team of doctors, nurses, social workers, and chaplains, collaborates to create a personalized care plan. Family involvement is encouraged, and bereavement support is provided. Hospice care is covered by Medicare, Medicaid, and most private insurance plans, encompassing medical services, medications, and necessary equipment.

How does hospice care differ from hospital care?

-Hospice care and hospital care serve different purposes and are designed for different stages of a patient’s illness, focusing on distinct goals:

Purpose and Goalsof Hospice Care

The primary goal of hospice care is to provide comfort and improve patient quality of life for those who are nearing end of life, with a life expectancy of six months or less. Hospice care includes palliative care, manages pain and other symptoms, and addresses emotional, psychological, and spiritual needs. It is centered on comfort rather than curing the illness.

What is Hospital Care?

Hospital care is aimed at diagnosing, treating, and curing illnesses or injuries. It involves a range of medical interventions, including surgeries, treatments, and emergency care, to stabilize the patient’s condition, promote recovery, and potentially extend life.

Approach to Treatment with Hospice Care

In hospice, aggressive treatments aimed at curing the illness are generally discontinued. The focus shifts entirely to comfort care, symptom management, and supporting the patient and family through the end-of-life process.

Approach to Treatment with Hospital Care

Hospitals provide a wide range of treatments and procedures, surgeries, and treatments aimed at curing or managing diseases. including life-saving interventions. Care is often intensive and may involve multiple specialists working to improve or stabilize the patient’s condition.

Hospice Care Setting

Hospice care in nursing homes is provided and it can also be delivered at home, in hospice centers, or in hospitals, allowing patients to remain in a comfortable environment. Nursing home hospice care environments are aimed at making the patient as comfortable as possible.

Hospital Care Setting

Hospitals are medical facilities equipped with advanced technology and staffed by healthcare professionals to provide a range of treatments. The environment is clinical and geared toward providing intensive medical care.

Hospice Care Patient Population

Hospice is specifically for patients who have a terminal illness and are expected to live six months or less. It is chosen when the patient and their family decide to focus on quality of life rather than pursuing curative treatments.

Hospital Care Patient Population

Hospitals treat patients with a wide variety of medical conditions, ranging from minor injuries to serious, life-threatening illnesses. Hospital care is for anyone who requires medical intervention, regardless of the stage of their illness.

Hospice Care Family Involvement

Family involvement is a component of hospice care. Caregivers and family members have an active role in the care process. Support and counseling are provided to help families cope with the emotional and practical challenges of end-of-life care.

Hospital Care Family Involvement

Hospica care at a hospital is focused on medical treatment provided by healthcare professionals. Family members aren’t directly involved in daily care like they are in hospice.

Cost and Coverage for Hospice Care

Hospice care is covered by Medicare, Medicaid, and most private insurance plans, including medications, medical, and services related to the terminal diagnosis.

Cost and Coverage Hospital Care

Hospital hospice care costs vary depending on services provided and length of stay. Coverage typically includes a combination of private insurance, Medicare, or Medicaid, but patients may be responsible for out-of-pocket expenses.

Comparing patient care approaches in hospice and hospital settings

Hospica Care Approach to Treatment

Hospice care focuses on palliative care, managing symptoms rather than curative treatments, to ensure patient comfort and dignity in the final stages of life. Hospital care adopts a more aggressive approach, using medical technologies and procedures to treat or cure illness, aimed at recovery or stabilization, prioritizing comfort only in critical situations.

Patient Autonomy and Family Involvement

In hospice care, patients and families play a central role in the care process; a hospice team ensures care aligns with their values and preferences while providing supportive counseling. In hospital care, medical decisions are driven by healthcare professionals, with family involvement mainly in critical cases.

Hospica Care Environment

Hospice care is provided in a comforting, familiar environment like the patient’s home or a hospice facility, designed to create a homelike atmosphere with minimal medical equipment. Hospital care occurs in a clinical, sterile setting with medical equipment, focused on delivering essential treatments.

Hospice Care Continuity

Hospice care provides continuous support with ongoing care, maintaining the patient’s comfort until end-of-life. In hospital care, continuity varies with the patient’s condition and involves specialists and frequent changes in the care plan based on the patient’s response to treatment.

Hospice Care Symptom Management

In hospice care, symptom management alleviates pain and discomfort to ensure patient comfort. In hospital care, symptom management is secondary to treating the underlying disease, with the primary focus on curing the illness or stabilizing a critical condition, incorporating pain relief.

End-of-life care: Hospice vs. hospital: What are the benefits of early hospice referral?

The benefits of an early hospice referral include better symptom management and improved quality of life for the patient. Hospice teams provide care earlier in the illness. It also allows for more time to address the emotional, psychological, and spiritual needs of the patient and their family, reducing stress and anxiety. Early referral avoids unnecessary hospitalizations and medical interventions, allowing patients to spend more time in a comfortable environment.

When is the right time to consider hospice care?

The right time to consider hospice care is when a patient with a serious, life-limiting illness has a life expectancy of six months or less. When curative treatments are no longer effective or desired, the focus shifts. Consider hospice care if the patient is experiencing frequent hospitalizations, a decline in health, or increasing difficulty managing symptoms at home.

How to have conversations with healthcare providers about hospice

When discussing hospice with healthcare providers, approach the conversation with clear questions about the patient’s prognosis and care options, and how hospice can improve quality of life. Be honest about your concerns and needs; ask for detailed explanations of what hospice care entails and how it can benefit your loved one.

What criteria should be considered when selecting a hospice provider?

When selecting a hospice provider, check the provider’s accreditation and licensing to verify they meet regulatory standards. Assess the range of services offered to ensure they can meet your loved one’s needs, including both medical and emotional support. Evaluate the qualifications and experience of the staff, as this directly impacts care. Consider how the hospice works with nursing homes if applicable, and gather patient and family feedback to gauge their reputation and care satisfaction.

Important questions to ask when choosing a hospice

When choosing a hospice, it’s essential to ask several important questions to ensure the best care for your loved one. Ask what services are included in hospice care and how pain and symptom management is handled.  The answers will give insight into the quality of life the patient will experience. Ask about the support available for families, including counseling and respite care. Finally, clarify how care plans are developed and updated to meet the evolving needs of the patient.

Why include hospice care in your advance care planning?

Include hospice care in your advance care planning to have a clear plan for comfort-focused care if your condition becomes terminal. Hospice care prioritizes quality of life, symptom management, and emotional support, whereas hospitals focus on curative treatments that may not match your end-of-life wishes. Planning ahead with hospice in mind gives you control over your care and eases the decision-making burden on your loved ones.

Also Read: A Guide for Causes of Disorientation and Confusion in Elderly