70% of Americans are not aware of the benefits of palliative care. Yet a recent poll found that once they were informed of its purpose, 92% said that they would use it if a medical situation was applicable. Unfortunately, many physicians do not discuss palliative care with their patients. If they do, it often is not discussed early enough in the patient’s disease process so symptom relief can occur sooner than later.
So what is palliative care? By definition, palliative means providing relief. The goal of palliative care is to provide specialized pain management and symptom relief that occur from a chronic or serious illness. Individuals faced with health issues caused by cancer, heart disease, arthritis, dementia, kidney failure, or any other chronic or serious illness can benefit from palliative care.
Symptom relief and symptom management can include, but not be limited to, nausea, shortness of breath, emotional or physical pain, loss of appetite, sleep deprivation, anxiety and depression. Palliative care enables a person to improve their quality of life by focusing on both the physical and emotional well-being of a patient. A person of any age and at any stage of their disease process can receive palliative care.
Palliative care is a different service program than hospice. Many people are familiar with hospice services. Hospice is a program offered by local hospitals and nonprofit/for-profit organizations for end-of-life care. Hospice is a type of palliative care since they strive to reduce symptoms of a serious illness. However, hospice is used for individuals who have been diagnosed with a terminal illness and your physician feels that you have less than 6 months to live if your disease runs its typical course. Because of this prognosis, you are not able to continue medical treatments that may cure your disease if you are under hospice care.
On the other hand, palliative care does not require you to be diagnosed with a terminal illness or have received a prognosis of less than 6 months to live. More importantly, you are allowed to continue to receive medical treatments that may cure your disease.
Who pays for palliative care? Palliative care is typically an outpatient specialty service that bills under your Medicare Part B. Medicaid beneficiaries also are able to receive palliative care as well as some private health insurance plans will include coverage. Sometimes palliative care can occur in a hospital setting for a short period of time and then the care can continue at one’s own home. Unlike hospice care, Medicare does not cover the cost of palliative care drug prescriptions. If someone does not have the ability to pay for palliative care, most organizations will not turn away a patient that needs this service. You just need to ask!
A palliative care team is typically available through a local hospice organization or a hospital-based palliative care team. More hospitals are embracing palliative care and building teams to service their patients. This program is inline with the current objective of hospitals and medical providers to focus on patient-centered healthcare and to treat the whole person.
In 2000, 24% of the U.S. hospitals had palliative care programs. In 2009, that number increased to 63%. Unfortunately, there are not enough palliative care specialists for the growing demand. Currently, there is one trained palliative care physician for every 1200 Americans living with a serious or chronic illness. The U.S. healthcare system currently pays doctors primarily for conducting procedures. Doctors are trained to cure a medical condition. But if a cure does not exist, a person still needs medical expertise on living with the disease and its symptoms. Many hospitals are trying to determine how to offer this service within their business model and still be profitable.
Recent research has shown that palliative care can reduce healthcare usage by $6 billion a year. A palliative care patient is less likely to be taken to an emergency room since regular, individualized care is provided. Furthermore, patients receiving palliative care are more likely to have discussed end-of-life decisions with their family and/or doctors. This equates to fewer patients being resuscitated or intubated against their will.
If you or a loved one is one of the 90 million Americans living with a serious or chronic illness, you should ask your doctor if palliative care will improve your daily life. A free consultation by a palliative care team is always an option if you want to better understand the scope of their services and your eligibility.