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After Death Occurs Checklist
Hospice and Palliative Care
Over the past few decades, specialized programs for people living with life-threatening conditions have become available. These programs can be invaluable resources for patients, their family, and friends coping with the demands of serious illness. Here are some programs that may be available in your area.
Hospices provide end of life care to patients when the goal of treatment shifts from cure to comfort, usually in the last six months of life. The hospice philosophy recognizes the importance of living out the remaining months with respect and dignity in an environment that promotes quality of life. Hospice care can be provided at home or at assisted living facilities, nursing homes, hospitals, and residential hospice houses.
Hospice care is provided by an interdisciplinary team -including a physician, nurse, social worker, chaplain, home health aides, and volunteers. The hospice team complements the role of your physician by addressing pain and symptom management and meeting the medical, emotional, and spiritual needs of you and your family. Because hospice care includes the family, bereavement services continue after the death of the hospice patient for up to 13 months.Hospice care is available in every Massachusetts community through the services of one of the state's 40 licensed hospices. Comprehensive hospice care is covered for Massachusetts residents under Medicare, Medicaid, and private insurance carriers. The hospice benefit covers all care, drugs, and medical equipment related to the terminal illness. However, a basic hospice principle is that no patient will be turned away because of an inability to pay. Medicare hospice regulations require patients to no longer be seeking curative treatment and to have a life expectancy of less than six months should the disease run its normal course.
Palliative care services have been around in various forms for several years. New guidelines for palliative care were developed in 2004. Interdisciplinary palliative care programs can now be found in some hospitals, rehabilitation facilities, nursing homes, and visiting nurse agencies. These programs reflect a growing interest among healthcare professionals in improving the care and quality of life for individuals with serious and life-threatening conditions in non-hospice settings. In many ways, the goals of palliative care are similar to those of hospice care. These include providing resources to help control pain and symptoms, exploring advance directives, and addressing psychological, social, and spiritual issues.
However, there are differences between hospice and palliative care. Palliative care may be provided at any time during the course of a life-threatening condition, may last from actual diagnosis to death, and may occur along with curative treatment efforts. Patients on clinical trials are also eligible for palliative care. It is possible to be cared for within a palliative care program and then be admitted to hospice in the final months of life.
At this time, there is no specific insurance coverage for comprehensive palliative care other than for pain and symptom management. However, many insurance carriers will cover pain and symptom management under general care.
For more information or help locating a hospice or palliative care program near you, contact:
Hospice and Palliative Care Federation of Massachusetts
1420 Providence Highway, Suite 277, Norwood, MA 02062
The National Hospice and Palliative Care Organization
1700 Diagonal Road, Suite 300
Alexandria, VA 22314
The National Consensus Project
Representing a consortium of national palliative care organizations, have established Clinical Guidelines for Quality Palliative Care, which are available at the website noted.
The Center to Advance Palliative Care (CAPC)
A national initiative supported by The Robert Wood Johnson Foundation, with direction and technical assistance provided by the Mount Sinai School of Medicine (NY). CAPC provides healthcare professionals with the tools and training necessary to start and sustain successful palliative care programs.