Franklin –  When former First Lady Barbara Bush chose to seek comfort care measures rather than further hospitalizations and curative measures, conversations and questions about what Comfort Care entails arose. What exactly is Comfort Care? How is it different from Palliative Care or Hospice Care? How should individuals and their families approach End of Life care decisions?
To help you make decisions for yourself, or to help you start the conversation with your loved ones, Franklin VNA & Hospice, a certified provider of home hospice services, has provided a brief explanation of different options for care at the End of Life
Comfort Care refers to a plan of care that is focused on symptom control and stress relief to provide quality to the end of life process. Comfort Care can be provided at home with a care agency or by the staff of a long term care facility. Coverage of services are dependent on individual insurance plans.
Palliative Care is care which is provided either with curative treatment or after treatment has stopped, and is both patient and family-centered and focused on relief of the stress and symptoms of a serious illness to improve quality of life. An example of this is treating the nausea and fatigue for a patient with cancer, while they are continuing to receive chemotherapy in an effort to cure that cancer.  
Hospice Care is a benefit an individual is eligible for with Medicare, most private insurances, and Medicaid. Hospice Care focuses on relieving the stress and symptoms of a terminal disease that is at a point when an individual no longer wants to seek treatment. It is provided by a Visiting Nurse Association certified as a Hospice provider or through a for-profit private Hospice care group. It can happen in the home, in a hospice house or in a long term care facility. The Hospice benefit can cover medication costs associated with your illness, equipment such as a hospital bed, or oxygen, and pays for not only the nurse to visit you but also provides emotional, psycho-social and spiritual care delivered by an Interdisciplinary team of professionals that may include a physician, nurse, social worker, allied therapists, counselors, home health aides, spiritual and grief support, and trained volunteers. You can get all these extra support people even if you are living in a long term care facility, in addition to the regular staff, or they will come to your home to help your caregiver at home to provide your care. Because Hospice is intended for those with terminal illnesses, to be eligible to exercise this benefit an individual must have a prognosis of six months or less within the doctor’s best estimation. However, hospice can be provided for as long as the individual needs it and is not limited to six months if the doctor certifies the need for it.
Hospice care must be provided by a certified Hospice provider, and includes a dedicated care team focused on helping the person on hospice reach his or her life goals and support for family and loved ones even after the person on hospice has died. For instance, since you do not need to be home-bound to be on Hospice Care, a person on hospice who has a goal to attend her daughter’s wedding would have care and symptom relief focused around allowing them to make that trip. Or if perhaps dying at home without pain is a person’s goal, then the care for that person would be centered around his pain relief and coordinating support for his caregivers to allow him to remain in his home comfortably. Hospice care is individualized for each person’s unique goals and provides the most comprehensive array of covered services.
Lori Bishop, NHPCO (National Hospice and Palliative Care Organization) Vice President of Palliative and Advanced Care said “One of the biggest misconceptions about hospice is that it’s giving up…. Hospice provides high-quality care and support to the whole person and to family caregivers with the goal of quality of life.”
National Healthcare Decision Day was April 16 and Barbara Bush chose her End of Life care with those options in mind. She died on April 17 in Houston, Texas with her family at her side.
To learn more about hospice and palliative care options please visit NHPCO’s Caringinfo.org.