It has been widely reported in a statement from the Bush family that former First Lady Barbara Bush has decided to forgo further hospitalizations and curative-focused medical treatments and has chosen to receive comfort care. Questions have come in to
NHPCO asking for further details about what makes up comfort care.Comfort Care refers to care plan for the patient that is focused on symptom control, pain relief, and quality of life. Often support is provided to family members to help them understand the care plan and to address needs and concerns they might have.
There are different forms of comfort care. Two of the best known are hospice and palliative care.
Under hospice care, a person receives medical care as well as emotional, psycho-social, and spiritual care delivered by an Interdisciplinary team of professionals that includes a physician, nurse, social worker, allied therapists, counselors, home health aides, spiritual and grief support and trained volunteers. Each person’s care plan would be tailored to his or her specific needs with some patients requiring services that others might not need.
Palliative care means patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. Palliative care throughout the continuum of illness involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice.
“Under the philosophy of hospice and palliative care, the goal is care and not cure,” said Edo Banach, President and CEO of NHPCO. “The same principles would apply to comfort care.”
Under the Medicare hospice benefit, a person 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 patient needs it and is not limited to six months. Palliative care provides care and services without the required six month prognosis and can be provided alongside curative or life-prolonging treatment.
Hospice care serves people coping with cancer, dementia, heart disease, COPD, renal disease and other illnesses. The majority of hospice care is provided in the home, yet hospice care also is provided in nursing homes, assisted living facilities, and in-patient settings.
Comfort care would reflect the principles of hospice and palliative care, specifically designed to meet the needs of the individual patient and family caregivers. Hospice care provides the most comprehensive array of covered services. In the U.S., hospice organizations are the primary providers of community-based palliative care and comfort care services.
“If a family is struggling with a serious or life-limiting illness, it is never too early to reach out to your local hospice and ask about care they offer and if it might be right for a loved one,” Banach said.
While more than 1.5 million patients avail themselves of hospice care every year, nearly 30 percent of Medicare beneficiaries received care for seven days or less, which hospice professionals consider too short a time to fully take advantage of all that hospice offers.
“One of the biggest misconceptions about hospice is that it’s giving up,” said Lori Bishop, NHPCO Vice President of Palliative and Advanced Care. “Hospice provides high-quality care and support to the whole person and to family caregivers with the goal of quality of life.”
“It seems appropriate to share this information on April 16, National Healthcare Decisions Day, a day of national outreach to raise awareness of the importance of talking about one’s health care wishes and taking steps to share those preferences,” noted Banach.
Learn more about hospice and palliative care at NHPCO’s Caringinfo.org.