Palliative (supportive) care is an incredibly important approach that improves the quality of life for patients with life-threatening illnesses. Although often confused with hospice, this approach is very different. Join Dr. Andrew Esch as he explains the differences between palliative care and hospice, and provides tips for you to support your loved one.

1. An initiative of the Center to Advance Palliative Care
Understanding Supportive Care: What
Every Caregiver Should Know
Andrew E. Esch, MD, MBA
Center to Advance Palliative Care
November 1, 2022

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Todays Agenda
➔Define what Hospice is
➔Define Palliative Care
➔Frequently asked questions
➔www.GetPalliativeCare.org

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LIVING WITH SERIOUS ILLNESS IN THE
USA

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Fact:
➔Treating the pain, symptoms, and stress of
serious illness and its aftermath is as
important as treating the illness

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While Clinicians Focus On Curing/Treating
Your illness, You Struggle With…
➔Anxiety/worry
➔Shortness of breath
➔Constipation
➔Fatigue
➔Stress
➔Peripheral neuropathy
(Source: LCA Needs Assessment Survey, 11/15-2/16)
➔Pain
➔Weight issues
➔Nausea
➔Memory problems
➔Depression
➔Cough
➔And more

6. An initiative of the Center to Advance Palliative Care
It’s Really Not That Complicated
➔When serious illness strikes - we want:
– To achieve cure or keep the disease in check
– Maintain good functioning and quality of life
– To have coordination and connection of care
– Support to help us make informed decisions

7. An initiative of the Center to Advance Palliative Care
How Well Does The Health Care
System Meet These Challenges?
Uh-Oh!

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How Well Does The Health Care
System Meet These Challenges?
➔We are a “sick-care”, technology, and disease-
driven system that shortchanges quality of life
➔Most doctors are not trained to assess OR
adequately address pain, symptoms, and
distress when it comes to serious illness
➔We need to do better about these issues faced
by patients and survivors

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We Need to Put People
at the Heart of Health Care
➔ Move to “person-centered” care
– Recognize patients’ health problems as they see
them
– Focus on the whole person
– Include caregivers in the unit of care
– Provide a foundation for better recognition of health
problems and needs over time
– Facilitate appropriate care for these needs in the
context of other needs

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LET’S TALK ABOUT PALLIATIVE CARE
How Do We Make This Happen???
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What is Palliative Care?
➔ Specialized medical care for people living with a with serious
illness that focuses on providing relief from the symptoms and
stress
➔ The goal is to improve quality of life for both the patient and
the family
➔ Palliative care is provided by a specially-trained team of
doctors, nurses and other specialists who work together with
a patient’s other doctors to provide an extra layer of support
➔ It is appropriate at any age and at any stage in a serious
illness, and it can be provided along with curative treatment

12. An initiative of the Center to Advance Palliative Care
What’s The Ultimate Goal
of Palliative Care?
Providing those dealing with serious illness the best of what
medicine has to offer in terms of cure and disease-targeted
treatment
+
Providing the best of what palliative medicine has to offer in
terms of symptom management and quality of life
➔ To improve high quality of life

13. An initiative of the Center to Advance Palliative Care
Low Public Awareness of Palliative Care
Q: How knowledgeable, if at all, are you about Palliative Care?
National survey of
800 adults age 18+
June 2011.
Commissioned by
CAPC, ACS &
ACS CAN.

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Once Informed About Palliative Care
➔92% would be likely to consider Palliative Care
for themselves or their families
➔92% believed patients should have access to
Palliative Care nationwide
➔95% said patient & family education re:
Palliative Care as part of treatment is
important
(Source: National survey of 800 adults age 18+, 6/11, CAPC, ACS & ACS-CAN)

15. An initiative of the Center to Advance Palliative Care
The Impact of Palliative Care
➔Relieves pain &
symptoms
➔Patients may
live longer
➔Better family
support
➔Reduces
hospitalizations &
emergency
department visits
➔Reduces
unnecessary tests,
procedures
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Treat The Person Beyond The Disease

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LET’S TALK ABOUT HOSPICE
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Hospice
➔ To qualify for hospice care, these are the general
requirements:
• Life-limiting illness, prognosis is 6 months or less if the
disease takes normal course
• Live in the service area
• Consent to accept services
• Forgo other medical interventions for the terminal illness
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Hospice
• Provides a range of services:
• Interdisciplinary case management
• Pharmaceuticals
• Durable medical equipment
• Supplies
• Volunteers
• Grief support

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Hospice: Who Provides The Care

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Hospice: Where It Is Provided
• Home – the patient’s or loved one’s home
• Nursing Facility
• Assisted Living Facility
• Hospital
• Hospice residence or unit
• Correctional setting, homeless shelter – wherever
the person is located

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Hospice: Who Pays?
• Medicare
• Medicaid
• Insurance and HMOs
• Private pay
• Sometimes a combination of these…

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PUTTING IT ALL TOGETHER
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24. An initiative of the Center to Advance Palliative Care
IF You Remember Anything From
Tonight:
➔ Palliative Care is Based on Need
– Available from time of diagnosis
– Focuses on comfort and quality of life that may be
provided with other curative or life prolonging treatments.
➔ Hospice is Based on Prognosis
– Patient expected to die in next 6 months
– Focuses on comfort and quality of life when a cure is not
possible with specialize care and services.
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25. An initiative of the Center to Advance Palliative Care
Summary: Hospice vs. Palliative Care
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Hospice Palliative Care
When Can You Have It? Prognosis < 6 months Any Time
Who Provides It? Hospice Team Palliative Care Team
Concurrent with Disease
targeted or Current
Treatments?
No Yes
Who Pays For It? Special Insurance Benefit Medical Insurance
Where Can You Have It? Usually at Home, Can Be
In Facilities
Anywhere
What is Provided? A Team That Consists of
Doctor, Nursing, Social
Work, Chaplaincy
A Team of Specialists –
variable team make-up

26. An initiative of the Center to Advance Palliative Care
Visit
www.getpalliativecare.org
to learn more.

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QUESTIONS