Question: Most recently my frail, elderly mother fell in her home and has multiple chronic physical conditions needing more support. My mother has chronic kidney disease stage 4, but not to the point of dialysis. Her condition leaves her feeling very weak and fatigued. Even with a caregiver helping with daily needs, she needs more medical care and support. Her primary physician recommended we contact ADRC to inquire about palliative care and hospice options. Is my mother a candidate for either of these programs, and if so, is there a cost or will Medicare insurance cover it?
Answer: Thank you so much for reaching out and connecting with ADRC to discuss your mother’s needs for palliative care vs. hospice services and insurance coverage.
Hospice is a service for individuals residing in their home or a facility that are experiencing life limiting illnesses with a prognosis of six months or less to live. These services include medical care, pain management, spiritual and emotional support, as well as bereavement services and grief counseling. Your loved one would receive a hospice team of professionals including a nurse, social worker, and bereavement specialist within their current living setting. Medicare and Medicaid plans, as well as most private or managed care insurance plans, cover these services.
Please contact ADRC for a listing of the different agencies that offer hospice services in Brown County.
Palliative care is a services for those residing in their home or a facility that are experiencing any serious illness or injury that can be life limiting and debilitating. This does not require a prognosis of 6 months or less. The palliative care team includes doctors, nurses, and specialists with a focus on the physical, emotional, and spiritual needs of your loved one. If your loved one needs more assistance with bathing, medications, pain management, and treating the symptoms, this may be an option. This service can also provide support in treatment options and decision making with medical goals.
Frequency of visits are based on diagnoses and needs. This service is not generally covered by Medicare or Medicaid; however, there are some Medicare Advantage Plans that cover palliative care services. Some offer sliding fee scales. You will want to contact your loved one’s insurance to verify this coverage.
I hope this helps in understanding the differences and provide guidance for both you and your mother. Please contact an ADRC Specialist for a listing of the different agencies providing palliative care and to further explore resources and options.
