Hospice: what you need to know about end-of-life care

WHAT IS THE DIFFERENCE BETWEEN PALLIATIVE CARE AND HOSPICE CARE? “Hospice is a type of palliative care, but not all palliative care is hospice,” Baird says. Patients receiving palliative

care have serious or chronic illnesses but can still be undergoing curative treatment for their condition. Under hospice, patients have either decided not to receive more treatment for their

life-threatening illness, or there is no more curative treatment to be offered. Under either system, patients and families will find interdisciplinary teams that work with them to alleviate

not only the pain but also the stress of living with a serious or terminal condition. "And both systems excel at symptom relief," Novas says. Entering hospice doesn’t mean

patients can’t get medical care for other, unrelated conditions. For example, says Novas, a hospice patient who has pancreatic cancer won’t receive more cancer treatment, but Medicare will

still cover their treatment for glaucoma. Patients who change their minds and want more curative treatment for their primary illnesses can revoke hospice at any time. “It’s always the

patient's choice,” Baird says. ROLES OF CAREGIVER, HOSPICE WORKERS “The role of hospice has always been to supplement the caregiving that is already being done by either family members

[or] nursing home staff, if they’re in a nursing home, or paid caregivers. Hospice does not take over that caregiving role. We supplement it,” Novas says. HOSPICE USE FOR END-OF-LIFE CARE

More than 1.7 million Medicare beneficiaries used hospice care in 2021, the most recent data available, according to the National Hospice and Palliative Care Organization. Fifty-three

percent were women, and most were over 75. Younger patients who died were less likely to use hospice care. Among Medicare patients who died: * Younger than 65: 25% were in hospice * 65 to

74: 36% * 75 to 84: 48% * 85 or older: 61% _Source: National Hospice and Palliative Care Organization Facts and Figures, 2023_ Hospice doctors and nurses oversee medical care and manage pain

and other symptoms. They’ll also teach the family how to provide end-of-life care for their loved one. “What that can look like is a nursing aide coming three times a week for about an hour

and a half each time on average[and] people get a visit by a registered nurse every week,” Novas says. Social workers and clergy provide support to both patient and family members to help

with the emotional, psychosocial and spiritual aspects of dying. “What’s hard is the family caregiver has been in the mode of taking care of the patient for so long … and keeping that

positive hope alive,” says AARP caregiving expert Amy Goyer. “Now you are flipping and not fighting that fight anymore, but you are focusing instead in fighting the fight for their comfort

and following their wishes.” Hospice will also take charge of ordering equipment. Durable medical equipment such as hospital beds as well as personal care and sanitation items, “that’s all

provided and delivered to the door,” Novas says. “It's one less thing that [caregivers] have to do and it's one less thing that takes them away from focusing on the person that

they're losing.” HOW TO FIND HIGH-QUALITY CARE A caregiver should research hospice agencies and identify the top choice or choices before this care is needed, experts say. * ASK FOR

RECOMMENDATIONS from doctors, nursing homes, friends, family members and anyone who has knowledge of hospice care. * LOOK AT CARE COMPARE on the Medicare site. Hospices are searchable by zip

code, and you can compare ratings of different providers in your area. * VISIT HOSPICE FACILITIES or agencies in person to determine how you feel about the people you meet.