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Understanding Palliative Care: A Conversation With Morgan McCall



You may have heard the terms “palliative care” used interchangeably with “hospice” or “end-of-life care.” However, palliative care and hospice are actually quite different from each other.

Studies have shown that a poor understanding of this distinction often leads to an underuse of palliative services, which can increase preventable suffering for patients.

To get a better understanding of what palliative care role is in the care continuum, Morgan McCall, Director of the Palliative Care Program at Intrepid USA, answers some of the most common questions about palliative & supportive care.

Q: What is Palliative Care?

A: The meaning of Palliative Care (pronounced pal-lee-uh-tiv) or “Supportive Care” is specialized medical care for people living with a serious illness. It focuses on providing patients relief from the symptoms, pain, and stress of their condition. The goal of palliative care is to improve the quality of life for the patient. Palliative clinicians do not take over care of the patient but rather collaborate directly with the patient’s entire care team members to provide an extra layer of support.

Q: How is Palliative Care different from Hospice?

A: Palliative care should begin at the time of diagnosis with any serious illness, and it is delivered concurrently with all disease-directed treatments and therapies. On the other hand, hospice care begins after treatment of the disease is stopped, and life expectancy is typically less than six months. The illness is considered terminal when you start hospice care.

Q: Can a patient pursue curative treatment and still receive Palliative Care?

A: Yes. Treatment choices are entirely up to the patient. They can receive palliative care at the same time as treatment that is meant to cure. The goal of palliative care is to identify and honor the goals, values, and priorities of the patients we serve while ensuring that we work together to build a care plan based on these goals.

Q: How can the patient and family benefit from Palliative Care?

A: Again, palliative care is an extra layer of clinical support. There are certain gaps in the healthcare system that palliative care addresses. These gaps include infrequent, late, or limited conversations about what matters most to the patient and their family; uncontrolled symptoms that can lead to preventable emergency department visits or hospital stays; the need to support exhausted caregivers; and sometimes poorly coordinated care across clinical teams or services. While most of the health care workforce cares for patients who have a serious illness or palliative needs and possess the opportunity to relieve suffering and improve quality of life in every clinical interaction, they are not always trained or supported to do so. Palliative care provides patients access to clinicians who are trained in symptom management, gives support to patients and families during difficult medical decision points, establishes patient’s priorities and goals of care, and improves outcomes, patient satisfaction, and quality of life while typically reducing healthcare costs.

Q: What are some of the services that Palliative Care provides?

A: Every palliative care program is different, so services can vary greatly. At Intrepid USA, our palliative care services are embedded within the home health program in select locations as a supportive element for patients with serious illness. We have specialty Palliative Clinical Coordinators working on the Home Health Care Team to co-manage and assist with each patient’s identified palliative needs through palliative assessment, counseling, goals of care discussions, and coordination of care with the patient’s physician. For psychosocial or existential needs, the Palliative Clinical Coordinators will request the assistance of a social worker, chaplain, or volunteer, as appropriate.

Q: Who provides Palliative Care?

A: Our specially trained palliative care nurses and therapists work together with the patient’s other care team members, including their doctor, to provide the best quality of life possible. For psychosocial or existential needs, the Palliative Coordinators will request the assistance of a social worker, chaplain, or volunteer as appropriate to support the patient and family. We are excited about the future growth of Intrepid USA’s Palliative & Supportive Care Program to eventually include advanced practice providers as well.

Q: When should Palliative Care begin?

A: You can have palliative care at any age, and any stage of a serious illness, but early in your illness is recommended.

Q: Where do patients receive Palliative Care?

A: Palliative care is offered in many settings, including hospitals, clinics, and the patient’s private residence. At Intrepid USA, our focus is community-based care, so we bring palliative care directly to the patient, wherever they call home.

Q: Does insurance cover the cost of Palliative Care?

A: Most insurance plans cover all or part of palliative care, just like other hospital and medical care services. This is also true of Medicare and Medicaid. With Intrepid USA’s Palliative & Supportive Care Program embedded within our Home Health Program currently, there is no additional cost for a palliative care visit outside of usual home health charges. Patients can check with their insurance company to verify home health benefits, as well as the provision for specialty palliative care.

Q: Can a patient receiving Palliative Care continue to see their regular physician(s)?

A: Absolutely! In fact, this is encouraged. The Palliative Care Team provides an extra layer of support and collaborates with everyone involved in the patient’s care, including their primary doctor.

If you are interested in understanding and learning more about Intrepid USA’s Palliative Care Program, please contact us here.

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