Non-Hospice Palliative Care

Hospice is one form of palliative care but unlike traditional palliative care, hospice has specific requirements a patient must meet. First, a patient must have a life-limiting condition with a life expectancy of six months or less. Two doctors are required to sign a legal document stating that a patient will likely die within six months if the illness or condition runs it's usual course. Second, the patient must sign a legal document that states they are giving up Medicare payment for curative treatments and aggressive care for their hospice diagnosis. Medicare pays for hospice under Medicare Part A and won't pay for curative or life prolonging treatment at the same time as hospice.

Unfortunately, these requirements are restrictive to many patients. Sometimes patients aren't ready to give up on aggressive, life-prolonging treatments. Non-hospice palliative care can help many of these patients get expert pain and symptom management without giving up their traditional Medicare coverage.

There are barriers to non-hospice palliative care. Availability of hospital-based palliative care programs are on the rise but may not be available in all areas. Misconceptions about palliative care are prevalent, even among doctors and nurses. As long as the belief that palliative care is only for dying patients persists, it will always be a stumbling block. Another area that is lacking is community-based non-hospice palliative care programs. If home health or hospice agencies expanded the care of their patients to include non-hospice palliative care, more patients could receive palliative care in their home.

How is your area doing in non-hospice palliative care? Does your hospital have a palliative care program? Does your area have a non-hospice community-based palliative care program?