According to data published by the National Library of Medicine, just over half of all Medicare hospice patients have cancer as their primary diagnosis. If a loved one in Cleveland, Ohio, is suffering from this disease, you know that chemotherapy is the accepted first-line treatment – and since you landed here, you’re likely wondering if that’s an option in hospice care.
The answer? In most cases, chemotherapy isn’t an approved treatment. The goal of hospice care is to provide support to patients and their families throughout the final stages of life. Services are designed to enhance comfort and well-being, not in the pursuit of a cure, and chemotherapy is generally regarded as curative care.
That being said, in certain situations, the treatment may be considered. Here, the Suncrest team explains when patients might receive chemotherapy and hospice care at the same time – and why this is rarely the chosen course of action.
The Concurrent Care Model
Hospice care is for terminally ill individuals with a life expectancy of six months or less, and in order for services to be covered by Medicare, Medicaid or any other form of health insurance, curative treatments must come to an end. As such, cancer patients typically have to forgo chemotherapy upon entering hospice care – and despite evidence showing that those who make this decision have a better quality of life, many people in this position are hesitant.
Stopping chemotherapy and starting hospice care can seem like giving up, despite ample evidence showing that hospice offers a better quality of life to individuals with advanced cancer. In light of this, some organizations are adopting a concurrent care model, which allows patients to receive hospice services and chemotherapy treatment at the same time.
Many cancer patients delay entering hospice care because they’re holding on to the idea that chemotherapy will be effective. The concurrent model of care is meant to ease the decision, as withholding treatment isn’t necessary. Researchers say that most individuals who receive both hospice services and chemotherapy end up stopping the treatment early on.
The Potential Impact of Chemotherapy
With certain types of cancer, chemotherapy has been proven to delay pain while breathing, slow the decline of appetite and hold back the onset of constipation. An improved quality of life can result even when the treatment isn’t expected to provide a cure.
Nevertheless, chemotherapy is an aggressive treatment, and it can come with a host of troubling side effects like fatigue, nausea, vomiting, numbness in the hands and feet, changes in bowel functions, skin rashes and mouth sores. These types of reactions impede the goal of hospice care, as they keep patients from being comfortable enough to enjoy the time they have left.
When chemotherapy is believed to be necessary to alleviate pain and other distressing symptoms, it may be recommended for a hospice patient, but the concurrent care model certainly has its objectors. Those against the concept worry that it ultimately does more harm than good, and not only in terms of the potential side effects of treatment. Critics say it allows doctors to sidestep conversations about end-of-life issues with patients and families, leaving them less prepared for the difficulties surrounding death.
Does the Medicare Hospice Benefit Cover Chemotherapy?
Medicare does allow hospice patients to receive chemotherapy if the treatment is for palliative purposes – or to put it another way, the intent must be to provide comfort and symptom relief, not to provide a cure.
Still, chemotherapy is rarely provided to individuals in hospice care. In part, this is due to the fact that the treatment tends to produce disturbing side effects. But, the total the Medicare hospice benefit pays is another big reason.
Agencies receive a set amount per day for in-home hospice care – roughly $200 for the initial period of routine home care, and after day 60, the payment drops to around $160. This is expected to cover all home medical equipment, medical supplies, medications, nursing visits, therapy treatments and much more. As chemotherapy drugs can cost nearly as much as the daily amount Medicare pays for hospice care, it’s highly unlikely for patients to receive the treatment under the hospice benefit.
Talk to the Team at Suncrest Hospice of Cleveland Today
Knowing that a loved one is nearing the end of life brings many challenges and concerns. Discussing treatment options with their doctor can be helpful, but you might also want to speak with a hospice professional.
Cancer patients rarely receive chemotherapy while in hospice care, but as we stated above, the combination is considered in certain situations. Decisions about care should always be based on individual circumstances, preferences and treatment goals, and it’s important to carefully consider both the potential positives and negatives, including the impact on quality of life.
Fundamentally, hospice is about providing support and comfort to those on the end-of-life journey, and given that cancer is a leading cause of death, anyone diagnosed with the disease should consider that eventuality. To learn more about hospice care, or to arrange for services for a loved one in Cleveland, Ohio, contact Suncrest today.
