Understanding Palliative Care

November is National Home CareHospice and Palliative Care Month, a time to celebrate our clinicians, but also a time to educate our community about these important services.

As November comes to a close, we focus on our third and final topic of the month:  Palliative Care.  Since the practice of Palliative Care began less than 20 years ago, there are still many opportunities to educate community members about the benefits of this important service.

In September 2014, Cornerstone VNA launched Palliative Care, an important new program to be included as part of the organization’s core services.  Thanks to Palliative Care, patients have received better symptom management, resulting in improved quality of life.  Although the program has experienced considerable growth over the past several years and is becoming more recognized as a specialty, there are still many questions about Palliative Care.  Learn more about this service and how it can benefit you or your loved one.

What is Palliative Care?

According to getpalliativecare.org, Palliative Care (pronounced pal-lee-uh-tiv) is “specialized medical care for people with serious illnesses. This type of care is focused on providing relief from symptoms and the stress of serious illness. The goal is to improve quality of life for both the patient and family.”

To do this, the Palliative Care team will:

  • Relieve your symptoms and distress
  • Help you better understand your disease and diagnosis
  • Help clarify your treatment goals and options
  • Understand and support your ability to cope with your illness
  • Assist you with making medical decision
  • Coordinate with your other doctors

Palliative Care is meant to be a supportive and adjunctive service to a patient’s other care providers. It does not take the place of a patient’s specialist or primary care provider.  Instead, it is meant to offer a different perspective to patients and families regarding their care with a focus on symptom management and comfort. Our Nurse Practitioners and Certified Palliative Care Registered Nurses provide care to address the symptoms of pain, shortness of breath, anxiety, nausea, bowels or other symptoms related to a serious illness.  Patients receiving Palliative Care are often still receiving treatments to cure or aggressively manage their disease and do not need to have a limited life expectancy.

The Get Palliative Care website adds, “Palliative Care will help you carry on with daily life. It will improve your ability to go through medical treatments. And it will help you to match your goals to your treatment choices.”

What is the difference between Palliative Care and Hospice Care?

Palliative Care is NOT Hospice Care. Often these are used interchangeably, but it is incorrect.  Frequently, patients need symptom management long before they are eligible for Hospice Care and Palliative Care can help bridge that gap.  Simply defined, Palliative Care is for the chronically ill and Hospice Care is for the terminally ill.  Hospice differs from Palliative because it is focused on providing comfort measures for the patient and any life-prolonging treatment is no longer provided.  Although some Palliative Care patients transition to Hospice due to the progression of their disease, some patients improve and no longer need services.

Who qualifies for Palliative Care?

Any patient with a chronic illness qualifies for Palliative Care.  It is appropriate at any age and at any stage of a diagnosis such as cancer, dementia, heart disease, lung disease, amyotrophic lateral sclerosis (ALS), Multiple Sclerosis (MS) or any illness that causes distressing symptoms.  Palliative Care focuses on symptoms and helps patients understand their treatment options so they have more control over their illness and can improve their quality of life.

A patient does not need to be confined to their home to receive this service and care can be provided wherever a patient lives: at home, assisted living facility, or nursing home.  Palliative Care can be accessed through a Home Care referral, community referral, provider referral or self-referral.

Who provides Palliative Care services?

The Palliative Care Program at Cornerstone VNA provides consultations and follow-up visits with a Registered Nurse and/or a Nurse Practitioner as well as visits from a Social Worker and a Spiritual Care Provider as needed.  Our Palliative Care team works with patients, their family members and physician(s) to help manage symptoms and establish goals of care.

What is the difference between Home Care Palliative Care and Community Palliative Care?

Home Care Palliative Care is for patients who are being seen under the home care benefit. At Cornerstone VNA, these patients are seen by one of our Palliative Care nurses.  Our nurses either provide case management for patients or provide consultations for symptom management.

Community Palliative Care is for patients who are either not eligible for home care or have been discharged from home care services and who have a chronic illness with uncontrolled symptoms, such as pain, anxiety or shortness of breath. Community Palliative Care is not meant to take over care from a primary care physician, but to help care for patients with chronic pain related to an injury or illness, like cancer or multiple sclerosis.  Patients receiving care from the Community Palliative Care program are seen by a Nurse Practitioner from Cornerstone VNA, who visits patients on a monthly basis to provide symptom management.

Who Pays for Palliative Care?

Source:  Start the Conversation, starttheconversationvt.org

Who pays for Palliative Care is a good question to ask when speaking to your doctor about starting Palliative Care. It is often handled much like a referral to a cardiologist, neurologist or other specialist and may be covered by Medicare, Medicaid or your private insurance.

Some illnesses and diagnosis may limit the ability to access care out of the home. In these cases, Palliative Care can be provided in the home by skilled nurses and therapists. Talk to your doctor to request a referral for home-based Palliative Care which is covered by Medicare under some circumstances.

If you have Medicare Part B (medical insurance), it may cover some treatments and medications that provide Palliative Care, including visits from doctors, nurse practitioners, and social workers. Medicare does not use the term palliative, so coverage is provided by standard Medicare Part B benefits. The Palliative Care provider (the organization offering you the services) will bill Medicare for services provided, but be sure you understand what co-pays or fees, if any, you will be asked to pay. Ask about your responsibility for fees and request a fee schedule before agreeing to receive services.

For additional information and specific coverage for Palliative Care services at Cornerstone VNA, please contact 800-691-1133.

You can also read our Blog Posts for Home Care and Hospice Care to learn more about these topics covered during this month of recognition.

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