Rochester Senior AdvisorWhat is the difference between hospice and palliative care?
Palliative care treats pain and symptoms at any stage of a serious illness alongside curative treatment, while hospice is comfort-focused care for someone whose doctor certifies a life expectancy of six months or less and who chooses to stop curative treatment for that illness.
Both use a team approach: physicians, nurses, social workers and chaplains. Palliative care is often hospital- or clinic-based; hospice usually comes to wherever the patient lives.
Who pays for hospice and palliative care?
Medicare's hospice benefit covers hospice in full for the terminal illness, including comfort medications and equipment, while palliative care is billed like other medical care under Medicare Part B or private insurance, with the usual cost sharing.
Neither pays room and board in an assisted living residence or nursing home.
Can hospice be provided in assisted living or a nursing home around Rochester?
Yes; hospice teams serve patients at home, in adult homes and assisted living residences, and in nursing homes, and residents can usually stay where they live when they enroll.
The state roster lists 5 hospice licenses with offices in the five counties: Livingston County Hospice, Rochester Regional Health Hospice Care, Supportive Care of Orleans, UR Medicine Hospice.
When should a family ask about hospice?
Ask when a parent has had repeated hospital stays, is losing weight and function, or when treatment is becoming more burdensome than helpful; many families say afterward they wish they had started hospice sooner.
Hospice can be stopped if a patient improves or wants to resume treatment, and restarted later.
What does hospice not provide?
Hospice does not provide round-the-clock caregivers at home, except for short periods of continuous care during a crisis; families still provide or arrange most day-to-day care.
Hospices also offer respite stays of up to five days so family caregivers can rest, and bereavement support for the family for about a year afterward.
Where is palliative care available around Rochester?
Palliative care is offered mainly through the area's health systems, UR Medicine and Rochester Regional Health, in hospital consult services and outpatient clinics, and some home care agencies provide palliative programs at home.
Ask the treating physician for a palliative care referral; it does not require giving up any treatment.
Can someone move from palliative care to hospice?
Yes; many patients receive palliative care first and enroll in hospice later, when they and their doctor decide comfort care should become the focus.
The palliative team can help with that transition and with choosing a hospice.
At a glance
| Hospice | Palliative care | |
|---|---|---|
| When | Life expectancy of six months or less | Any stage of serious illness |
| Treatment | Comfort-focused | Alongside curative treatment |
| Medicare | Hospice benefit, in full | Part B with cost sharing |
| Where | Home, residence or nursing home | Mostly hospital and clinic |
Sources include the N.Y. Social Services Law and Public Health Law, 18 NYCRR Parts 487-494, 10 NYCRR Parts 415 and 1001, Department of Health GIS messages, CMS, the VA and CareScout, as cited above; see our editorial standards.
