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What You Need to Know About Hospice and Palliative Care

Stria Staff March 17, 2020

Longevity market professionals should know the basic about end-of-life care. Get started here.

Both hospice and palliative care seek to improve quality of life, and provide emotional, physical, and spiritual support through a team-based approach. Hospice is used for individuals who have less than 6 months to live; palliative care can be used for individuals diagnosed with a disease that is life-limiting.

Not only do palliative care and hospice provide comfort to patients, but it also saves money for the health care system. Research as far back as 2013 found that, if 1,000 additional Medicare beneficiaries enrolled in hospice before death, the savings for Medicare would exceed $2.5 million. Palliative care also decreases the money spend on health care by reducing days in the hospital and emergency room visits.

These savings could be huge in our country, where we spend so much money on health care. In 2016, at least 1.43 million Medicare beneficiaries were enrolled in hospice. Yet only 14% of people who need palliative care actually receive it. These statistics show that it is important to educate consumers and longevity market professionals alike.

The following articles highlight the current state of hospice care and palliative care services.

Headlines & Insights: Curated excerpts from thought-provoking articles

Hospice Care Focuses on Making Life Comfortable for the Terminally Ill
The San Diego Union-Tribune  |  Lauren J. Mapp

Rosa Amarillas’ symptoms started with problems with her speech, followed by limping and trouble controlling her facial expressions. When she was finally diagnosed with Parkinson’s disease, she was told the neurodegenerative illness was terminal and she would have six to eight years to live.

It has now been nine and a half years since her diagnosis and her husband of 37 years, Mike Amarillas, has been by Rosa’s side as her caregiver the whole time…. At first, Mike said he was reluctant to sign her up for hospice care because he didn’t understand its purpose.

“I didn’t want her to think she was dying tomorrow,” Mike said. “I think eight out of 10 people think hospice is the last stop, and that it’s short.”

He’s not alone. A 2018 Cornell University study found that 37 percent of participants had an incorrect understanding of hospice and 53 percent misunderstood the definition of palliative care.

What Are Palliative Care and Hospice Care?
National Institute on Aging

Many Americans die in facilities such as hospitals or nursing homes receiving care that is not consistent with their wishes. To make sure that doesn’t happen, older people need to know what their end-of-life care options are and state their preferences to their caregivers in advance…

Palliative care can be helpful at any stage of illness and is best provided from the point of diagnosis….In addition to improving quality of life and helping with symptoms, palliative care can help patients understand their choices for medical treatment….

At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. Hospice is designed for this situation. The patient beginning hospice care understands that his or her illness is not responding to medical attempts to cure it or to slow the disease’s progress.

Ask the Expert: Hospice, Palliative Care Can Support Life Limiting Illnesses
Star Press   |  Karen Wells

Every year, 1.8 million people in the United States use hospice care and this number continues to rise.  Hospice is a service provide to individuals that have 6 months or less to live and are no longer receiving treatment for their illness. Palliative care can be started at the beginning of a diagnosis of a life limiting condition and can continue while the patient is being treated for the condition. They both focus on a team-based model to improve the quality of life of the patient and maintain comfort. Talking to your provider can help a patient decide if hospice or palliative care is the right course for a patient based on their illness.  

Broadly, home-based primary care programs have been shown trim cost, reduce unwanted high-acuity care at the end of life and enable patients to enter hospice earlier in the course of their terminal illness.

Hospice Providers Tout Bottom-Line Impact from Home-Based Primary Care Programs
Home Health Care News  | Jim Parker

As hospices seek new ways to engage patients further upstream, a rising number are diversifying their services to include home-based primary care, along with palliative care and other models. Evidence indicates that these primary care programs carry substantial benefits for patients and families—and can even have a significant positive impact on a hospice’s bottom line.

Staffing a Barrier to Palliative Care Growth
Hospice News  |  Jim Parker 

While the number of hospices and other organizations providing palliative care continues to expand nationwide, staffing shortages represent a barrier that threatens to slow this growth.

The United States has 13.35 hospice and palliative care specialists for every 100,000 adults 65 and older, according to an April 2018 study. The research estimated that by 2040 the patient population will need 10,640 to 24,000 specialists; supply is expected to range between 8,100 and 19,000.

Hospice and palliative care providers also experience shortages in non-physician disciplines, including chaplains, nurses, and social workers. 

Some Wonder Whether Hospice Puts Too Much of the Burden for Care on Families
Marketplace  |  Blake Farmer

In recent years, hospice care has grown into a $19 billion industry—the most profitable health care service line funded by Medicare.

Hospice agencies set patients up, often at home, with a hospital bed, pain medication and equipment. They send out nurses, health aids and social workers who support family caregivers. 

But as people increasingly die at home rather than the hospital, some palliative care advocates are now having second thoughts on its popularity, which has been led mostly by for-profit agencies and can put strain on families.

This story was created in partnership with students from the Department of Gerontology at Virginia Commonwealth University. Thanks to Meghan Beard for contributing research for this piece on suicide among older people.

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