What is the difference between hospice and palliative care?
Palliative care treats symptoms and stress of a serious illness at any stage and can go alongside curative treatment, while hospice is comfort-focused care for someone with a prognosis of six months or less who has chosen to stop curative treatment for that illness.
Palliative care is usually billed like other medical care. Hospice under Medicare is an all-inclusive benefit covering the team, medications and equipment related to the terminal illness.
Can someone receive hospice in Alabama assisted living?
A current Alabama ALF resident with a terminal illness other than dementia may receive hospice from a licensed provider and stay beyond 90 days if the facility can meet their needs, but an ALF may not admit someone who already needs hospice.
SCALF rules mirror that pattern. Ask a prospective community, before move-in, how many residents it has supported on hospice and what it would need to keep your parent there.
Where do Birmingham-area families find hospice?
ADPH licenses hospice providers; families can choose any licensed hospice that serves their area, and Medicare's Care Compare shows hospice quality measures and family survey results.
ADPH's directory lists 35 hospice providers with offices in the seven counties, 13 of them in Jefferson County. See the hospice roster.
When should a family ask about hospice?
Ask when hospitalizations are becoming frequent, when treatment is causing more burden than benefit, or when a doctor would not be surprised if the person died within a year; an evaluation commits you to nothing.
Many families say afterward they wish they had called sooner. Hospice support for caregivers, including bereavement services, continues after a death.
Can someone leave hospice if they improve?
Yes. A person can revoke the Medicare hospice benefit at any time and return to regular Medicare coverage for curative treatment, and can elect hospice again later if eligible; some people are discharged because their condition stabilizes.
Ask any hospice how it handles a patient who improves, and how it coordinates with an assisted living facility or nursing home when the patient lives there.
Who decides whether someone is eligible for hospice?
Two physicians, usually the attending doctor and the hospice medical director, certify that the prognosis is six months or less if the illness runs its normal course; the patient or legal representative then chooses to elect hospice.
Eligibility is recertified at set intervals, and people who live longer than six months can keep receiving hospice if they still qualify.
At a glance
| Hospice | Palliative care | |
|---|---|---|
| Timing | Prognosis of six months or less | Any stage of serious illness |
| Treatment | Comfort instead of cure | Alongside curative treatment |
| Payment | Medicare hospice benefit, all-inclusive | Regular medical billing |
| Alabama ALF | Allowed for current residents (not dementia) | No special rule |
Sources: Ala. Admin. Code chapters 420-5-4, 420-5-10 and 420-5-20; ADPH Bureau of Health Provider Standards; ADPH Health Care Facilities Directory and Deficiencies applications; Alabama DHR Adult Protective Services. See our editorial standards.
