The Power of Palliative Care – What can this Meaningful Service do for your Patients

Posted · Add Comment

In celebration of National Hospice month, Care Compass Network (CCN) would like to thank our 5 partner hospices, and to recognize all the wonderful things they do for our parents, children, siblings, friends, and loved ones each and every day.

Hospice Care and Palliative Care are two services that are often confused with each other, but are equally important services. We would like to make the distinction between Hospice Care and Palliative Care, and explain what they are all about.

What is the distinction between Hospice and Palliative Care

Hospice Care is for people who have been diagnosed with a terminal illness and have been given 6-months or less to live. Hospice focuses on caring, not curing, and in most cases care is provided in the patient’s home. Hospice Care also is provided in freestanding Hospice centers, hospitals, nursing homes, and other long-term care facilities. Hospice services are available to patients of any age, religion, race, or illness. Care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other Managed Care Organizations (MCOs)

How does Hospice Care work? Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to access the patient and provide additional care or other services. Hospice staff are on-call 24-hours a day, seven days a week. The team develops a care plan that meets the patient’s individual needs for pain management and symptom control. The team usually consists of: the patient’s personal physician; Hospice physician (or medical director); Nurses; Home Health ides; Social Workers; clergy or other counselors; trained volunteers; and speech, physical and occupational therapists, if needed.

Palliative Care is for people who have a serious illness that may or may not be life-limiting. Patients within a Palliative Care program still receive curative treatment that is patient and family-centered care to optimize quality of life by anticipating, preventing, and treating suffering. Palliative Care throughout the continuum of the illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information and choice. Palliative Care is provided and coordinated by an interdisciplinary team of the patient, family members, palliative and non-palliative health care providers that collaborate and communicate about care needs. Services are available concurrently with or independent of curative or life-prolonging care and the patient’s and families’ hopes for peace and dignity are supported throughout the course of the illness, during the dying process, and after death.

The Power of Palliative Care

Palliative medicine is one of the most impactful, yet least understood branches of medicine. Understanding what palliative medicine is, who can benefit from it, and what power it has will more health reform forward while improving patient outcomes and delivering results on the quality metrics sought through DSRIP. As most of palliative medicine is provided on a capitated rate, the cost of providing such care is controlled, predictable, and much less than many other avenues of care. CCN is leading the way in leveraging the power of palliative medicine to improve the lives of those our partners serve.

Palliative medicine focuses on making today the best day possible for the patient and their family. It focuses on minimizing and controlling whatever is causing distress for the patient. This includes physical symptoms such as pain, shortness of breath or weakness, but it also includes psychological symptoms such as anxiety, fear, or delusion. It also encompasses social symptoms such as loneliness and loss of independence. Spiritual needs and practical needs are also part of the scope of palliative care.

The focus of care for palliative medicine is the family, one of whom is dealing with a serious illness causing these distressing symptoms, not only the individual patient. Given this holistic scope of care and the focus on a broad spectrum of needs, palliative medicine is the one medical specialty that mandates an interdisciplinary approach to care. A wide range of skill sets, including medical, psychosocial and spiritual expertise, are necessary to provide palliative care.

Palliative medicine is appropriate for anyone coping with a serious illness that is causing distressing symptoms regardless of the stage or prognosis of the condition. There is a subspecialty within palliative medicine that focuses on patients with a terminal condition and that is known as hospice. Unfortunately, many see palliative care and hospice as the same thing, but they are not. Hospice is  subset or specialty within palliative medicine that deals with a specific population. It is analogous thinking that pediatric cardiology defines all of cardiology instead of a specialty within a much broader medical practice.

The impact of palliative care is tremendously powerful. Palliative Care has repeatedly been shown to increase length of life (even when provided as an alternative to aggressive curative care), decrease patient’s symptoms burden, increase patient satisfaction, increase provider satisfaction, lower the cost of care, increase the survivor’s length of life after a patient dies, decrease the psychosocial burden for the family, and increase the likelihood that the patient will remain at home throughout their lives.

The cornerstone of palliative medicine is patient-centered, holistic, home-based, cost efficient and impactful on a wide range of needs. It can be integrated into the treatment plans for almost all seriously ill patients. Fully educating the family of all care options, assisting the family in setting their care priorities, formalizing those priorities through advance directives, creating a care plan that is driven by the patient, empowering families to direct their own care, and advocating for the patient when needed is at the heart of how palliative medicine professionals practice.

Palliative medicine is by design a collaborative specialty. That is why it integrates perfectly with other medical treatments, including aggressive treatments. It actually can increase the effectiveness of other treatment modalities by minimizing the negative side effects of those treatments. When curative care no longer is brining benefit and the focus becomes just on palliative care, it may then be appropriate to bring in the specialty of hospice care. Hospice care has an associated insurance benefit that covers an inclusive array of services, including a complete interdisciplinary team, medical equipment, medication coverage, hospitalization, 24/7 coverage and bereavement support.

Outside of hospice, palliative medicine does not yet have an established reimbursement source. This causes a great deal of variability of what different palliative care programs offer, where they operate, what clinicians are involved, and who can access the services. Many payers, including Medicaid, are increasingly recognizing the power of palliative medicine and are building it into their care continuums. Care Compass Network is leading in this effort. CCN is working to integrate into the primary care services that Medicaid members receive, thereby improving the patient’s care while allowing them to remain in the community setting. Increasing access to palliative medicine can be one of the most effective ways to meet the elusive quadruple aim of healthcare reform – better care at a lower price with higher patient and provider satisfaction.

Hospice and Palliative Care Organizations within CCN’s 9-county Region

CareFirst is driven by our mission – affirming life through extraordinary, compassionate support and care for the seriously ill and grieving. We are called to do all we can to meet the needs of families who are coping with a serious illness, including helping patients stay in control of their health care through the end of their lives. One of the ways we meet this mission is through hospice care. CareFirst is the hospice provider for Chemung, Steuben, and Schuyler Counties since 1982. We are a team made of nurses, social workers, doctors, spiritual counselors, volunteers, grief counselors, and administrative staff who all work together to help families stay at home, making each day as comfortable as possible. We are able to provide the clinical care, psychosocial, and spiritual support, medical equipment, medications, short-term hospital care, physician coverage and 24/7 accessibility to support patients in their home. That home could be a nursing facility, assisted living facility, or most other settings. We continue to support the family even after the patient has passed through at least a year of bereavement counseling. This care is covered in full by Medicare, Medicaid, and most private insurances, and we have  sliding free scale to make care accessible to those without insurance coverage. Hospice is CareFirst’s heart, but we know that there are other ways for us to achieve our mission. We also support the seriously ill through palliative care programs, both in the hospital setting and in the community. These programs continue to grow and evolve, and will continue to promote the quadruple aim. Besides hospice and palliative care, CareFirst offers grief counseling to the community as a whole. This support can take the form of one-on-one counseling, support groups, family work, memorial services, alternative methods to address grief symptoms, children’s camps, teen workshops, holiday events, a lending library, support through the school, and much more. This professional support also continues to grow and evolve to further support the mental health needs of our community.

CareFirst continues to innovate and explore additional ways we can support our mission. This includes offering Care Transitions services to support those coping with illness be successful at home after an inpatient hospital stay. We are exploring new ways to identify patients who may benefit from the support of palliative medicine, and we are active on the state and national level to advocate for needed change in applicable regulation and legislation. We are looking to undertake research into increasing access to palliative medicine in rural settings. We are creating a learning lab where professionals as well as the community can grow their skills in the physical aspect of providing care in the home. We are active in expanding our local health care as part of Medicaid redesign efforts. All of this work is possible because of the extraordinary and committed people that make up our team. Their care, compassion, and skill better the lives of the families we serve. However, the true grace belongs to the families that we have the privilege to know through our care. Their strength and love are witnessed in countless ways every day. It is for them that we will continue to strive to meet our mission.

Catskill Area Hospice & Palliative Care, Inc. provides hospice and palliative care services to patients in Otsego, Delaware, and Schoharie counties. Driven by our mission to make life easier for patients and families facing serious illness, and a vision to provide sustainable world-class care, for every patient, every single time, Catskill Area Hospice & Palliative Care provides patients with choices, dignity and compassionate care. With values of passion, trust, positive energy, sense of humor, stewardship, and kindness, the Catskill Area Hospice & Palliative Care team is here to learn about your current circumstances and concerns, understand what is important to you, explore what services you qualify for – and to discuss your options, and ultimately to help you and your family feel better and live better.

Hospice & Palliative Care Services of Tompkins County has been a community resource since 1983, providing hospice care for people of any age with any terminal diagnosis. Our palliative care service specializes in relief of pain, symptoms, and stress at any point in an illness. Additionally, our bereavement support services provide grief counseling and support groups to those who are grieving a loss. Our job is to give you back your life for as much time as you have. This can be as straightforward as providing companionship and practical assistance or as complicated as controlling your pain, helping you talk to your family members, or working with you to resolve spiritual conflicts. Hospice treats the whole person and strives to meet all of your needs – physical, emotional, social and spiritual – as well as the needs of our family and friends. Our team includes a medical director, registered nurses, home health aides, social workers, a volunteer coordinator, a spiritual care coordinator, a bereavement counselor and volunteers. Professional care is provided by team members on a scheduled basis Monday through Friday and a registered nurse is on-call 24-hours a day, seven days a week. We can help you in your home, in an area nursing home, or in the Hospicare Residence.

Hospice of Chenango County, Inc is a non-profit health care agency that serves individuals with life-limited illness. We have cared for your family, friends, and neighbors for more than twenty years. Our experienced and compassionate staff comes to your home, nursing home, hospital room, group, or adult home to manage symptoms and keep you comfortable. Our hospice endorses a holistic approach to health care, with a deep understanding that serious illness often results in profound physical, emotional, and spiritual changes. We have experts in each of those areas to help patients and caregivers cope as the disease progresses. Our Palliative Care program is also holistic, and is designed for individuals with a serious illness, who may still be receiving life-extending treatment.

Lourdes Hospice has helped individuals with terminal illnesses live life to its fullest, up to the final moment since 1980. It is about receiving comfort and care when a cure is no longer possible. We focus specifically on comfort, dignity, and pain control by responding to the symptoms, needs and wishes of patients and their families. Our goal is to help each patient live each day to its fullest enabling them to remain in familiar and supportive environment surrounded by people they love and possessions they cherish. Hospice services patients that are no longer pursuing curative treatments an who would like to focus on comfort. This includes adults an children in the last few months of live. NYS residents of Broome, Tioga, Chenango, and Delaware Counties, and their families, are eligible for services with Lourdes Hospice. Lourdes Hospice is a compassionate team of professionals consisting of a medical director, a patient’s own primary care physician, registered nurses, social workers, spiritual care, hospice aides, and volunteers. Out team uses state of the art technology to provide the highest quality services and care. Sometimes a patient may need additional services, such as physical, occupational, or speech therapy to ensure their comfort and safety at home. If this need is identified, hospice will ensure that a dedicated Lourdes Therapist visits you in the comfort of your own home.

Hospice & Palliative Care Definition Source: National Hospice and Palliative Care Organization. Visit their website for additional information on each of these services.