What are the similarities and differences between hospice and palliative care? And when is each appropriate? Both specialized methods of care are important to patients and their families when they're going through difficult times. Today on At the Forefront, we'll talk about both types of care and what can be done to make people more comfortable. And our experts will answer questions. That's coming up right now on At the Forefront.
[MUSIC PLAYING]
We want to remind our viewers that today's program is not designed to take the place of a visit with your physician. Let's start off with having each of you introduce yourselves and tell us a little bit about what you do here at UChicago Medicine. And Dr. Ahmed Kahn, you're actually at the desk with me. So we will start with you.
Thank you for giving me this opportunity to talk about myself and our program. My name is Dr. Mohammed Ilyas Ahmed Khan. I'm the medical director of the University of Chicago Medicine Ingalls Memorial Hospital at University of Chicago Hyde Park and also Harvey, Illinois.
I am trained in internal medicine from State University of New York. I also have trained at Cleveland Clinic in hospice and palliative care with regards to the fellowship. And right now, I have been with the University of Chicago Medicine Ingalls Memorial Hospital and Hospice since February 2022.
OK. And Dr. Quadri, let's go with you now.
My name is Dr. Quadri. And I started working at U of C for the past few months. We have been incorporating and starting a new hospice program at Ingalls Memorial Hospital. And I look forward to the new innovations that we come up with.
And we're just going to start off with just a broad, general overview of what hospice and palliative care are. These are important things. And I think a lot of people don't realize how critical this is and how important this is to an individual or a family until, obviously, the time comes that they need to-- need to take advantage of these programs. And Dr. Khan, I'm going to with you if we can, and just have you tell us a little bit about hospice care. What exactly does it mean to go to hospice?
So in the United States of America, hospice is a Medicare benefit for patients who have a life expectancy of less than six months. And it's basically, the focus of the care is towards comfort and transition from curative treatment to more managing the symptoms so that they have a good quality of life for whatever quantity they have. And it doesn't mean that they have-- they need to have a life expectancy of exactly six months. Some people live beyond six months and some people graduate from hospice if they get better while they are getting these services.
Now, many of us have actually experienced this on a personal level with a family member or a loved one. And it is a difficult time. But I can say just from a personal level, and I'm sure there are many people watching that would say the same thing, what a valuable service this is, because it does make a tremendous difference in people's lives. And it is such a helpful thing for family members and, of course, the patient to make them comfortable. Can you explain to us a little bit about what happens with hospice care?
So hospice is a comprehensive service where the treatment is provided to the patient wherever they are at either at their home, in the hospital, or in the nursing home, wherever they are and their home is. And it comprises of providing services not just to the patient, but also to the family. And it is provided by a team of experts, including doctors, nurses, social workers, chaplains, nurses aides, music therapists, pharmacists.
They all work towards making the patients comfortable. They provide medications. They provide equipment. The goal is to enjoy the time they have for whatever quantity they have.
Give them kind of that valuable time with family members. Dr. Quadri, I want to talk a little bit about palliative care, because I think a lot of times people mix the two up. Can you tell us what that is and what differentiates palliative care?
Yeah, that's a great question. Palliative care is a service that is provided by palliative physicians. And we work with the oncologists. We work with heart failure specialists. And we work alongside with them to provide them, provide patients with the best symptom management that we can, the best ability to give them quality of life while they are getting treatment in chemotherapy, while they are getting treatments in heart failure clinic, and while they're getting treatments for many other illnesses as well.
So what are some of the palliative care services that are offered?
So number one, it's cancer-related pain. And that encompasses the majority of the patients that we have seen. But we also see patients with COPD. We also see patients with chronic obstructive pulmonary disease, congestive heart failure, Alzheimer's disease.
And some of the services that we provide is we give them medication that helps alleviate some of the symptoms that they are feeling. So that can be anything from narcotics to nausea and vomiting medication to constipation medication. And it really helps the patient feel comfortable while they're going through such a difficult time and going through serious illness. So we help with that.
And Dr. Ahmed Khan had mentioned a time frame for palliative care. And it's not, obviously, a hard-and-fast time frame. But is there something like that for palliative care or not?
So with palliative care, it can start at any time. I know there is a time frame with hospice care. But with palliative care, it could start at any time and it could end at any time.
Interesting. So do your teams work together quite a lot?
Yes. So we work with the physicians here at the Hyde Campus as well. And we started the inpatient hospice unit and also the services at the Harvey Campus. We work in close relationship with all the physicians at Harvey and also at the Hyde Campus. Some of the patients that are admitted here at the main campus at Hyde Park who needs inpatient hospice services are transferred and provided care at the inpatient hospice unit at Harvey Campus.
So when a loved one is in care and family members think they need hospice care, what is the process that happens at that point? You mentioned that there is some help from a financial standpoint as well.
So if anyone needs additional services, like hospice care, ideally it would require a doctor's order. But any family members can also reach out to our referral number. And we will reach out to the physician to get the physician order.
It's very easy. There are a lot of apprehensions and anxiety associated with the name of hospice. But we are there to support them. We are there to support you during this difficult phase of your life, either palliative care or hospice services.
And it's all different levels of support, which I thought was quite interesting and quite beneficial, because it's not only medical support. But as you mentioned earlier, it can be anything from chaplains to social workers. And that whole spectrum of care, I think, really makes a significant difference. And that's important.
Absolutely.
So tell us a little bit about home hospice care. That's something that I've heard of. And I think our viewers would love to have more information on that.
So most of the people who are enrolled into this Medicare hospice benefit are at home, and because they want to spend their time with their family and friends. So as I said earlier, the patients who are at home are provided home hospice services. They are provided with medications that are delivered to the home. They are provided with equipment, be it a hospital bed, bedside commode, shower table, oxygen. Those are all provided.
In addition to that, there would be professional people services, like home health aides coming and helping them as needed to help to keep the patients healthy and hygienic and clean. In addition, there would be a nurse visiting them. And that nurse will be available 24/7 on the phone. If anything happens, even in the middle of the night, she or he will be coming and visiting the patient, talking to the doctor, and making additional changes to the patient's treatment plan and to make the patient comfortable rather than calling 911 and going to the hospital. The goal is to enjoy the time as much as possible at home.
In addition, as I said earlier, there would be the ancillary support of the chaplain, social workers, and also the pharmacists who work in close relationship with the patients and their families. There would be additional services that are available for people who have passed away, which is called as bereavement support for the family members after the patient dies for at least 12 months.
And as far as palliative care services, where are those offered?
Those can be offered at the hospital. And it would be an outpatient setting a lot of the times. And physicians or nurse practitioners would go out to the house as well. So we have that service as well. And there are plans for the service to further grow. But majority of the time, the palliative services are provided from a clinic, an outpatient clinic.
And tell us a little bit about how that works. So if a patient, the patient's family knows that the patient needs palliative care, does their physician order that? Or how does it-- tell us, kind of walk us through the process, if you will.
So whenever an oncologist sees a patient and he feels that this patient's pain is getting out of control or he just needs some support, and he would give a recommendation and a referral to palliative medicine. And after that, they would get in contact with the palliative team. And the palliative team, which consists of social worker, nurses, and the physician, of course, they would just start seeing the patient. And after that, it's very comforting.
And that's something that can continue for quite some time, as you mentioned earlier, just to really provide for that comfort and that care for the patient, which again, these are such valuable services. And that's, obviously, why we're trying to get the word out, because I think more people need to know that this is available and it's not as challenging maybe as what you might think to get this type of care as long as your physician will help with that, because again, it's very important.
So both hospice and palliative care, now, both of you work at our Ingalls location primarily. But that's also a service, those are services that's available across the whole UChicago Medicine Network. Is that correct?
Absolutely. So we work in close relationship with the physicians here at UChicago medicine, especially the Palliative Care Department, along with the physicians who are in the hospital. We are intensivists. We coordinate with them to provide these services for the patients that need them, either in their home or in their nursing homes or wherever they are living, or an assisted living facility. Or if they need additional services, they can also be provided inpatient hospice services at our Ingalls Memorial Hospice Unit in Harvey, Illinois.
And is it the same with the palliative care as well?
Yeah.
Tell us a little bit about what that's like being a physician and working. And Dr. Quadri, I want to start with you, working with these patients that are going through very difficult times and being able to provide that level of comfort.
It is very emotional to be with the patients and their families. A lot of times there are tears that are being shed. And it's a personal connection that we have with these families, we have with these patients.
And it goes a long way, because at the end, they always thank us. They always are very happy with our services. And that's one thing that is very unique about palliative medicine.
Dr. Ahmed Khan, your thoughts on the same question?
Yeah, this is very difficult. And people have reservations to ask for help. But the thing is we have to understand there is help available. And a lot of people are hesitant because the taboos associated with death and dying.
But we have to understand, death is also part of our life. And this is, this is part of the process. And these patients need additional support. These are qualified, specially trained professionals in addition to the physicians who will be providing them care.
If you or if your loved one is looking for help, please reach out to us. And we will be happy to provide the necessary support you might need. There is no bad time to ask for help.
I agree 100%. Again, anybody who's been through this with a loved one knows what an important service this is and how beneficial the service is. It makes a tremendous difference. And I would strongly encourage anyone who's been through it. I've been through it personally and it made a significant difference.
Can you talk to us a little bit about health insurance? Because that is always something that comes up when people ask if there are costs associated, how those are covered, and how they can cover those.
Yeah, this is a very good question a lot of people ask, is this services, either palliative care or hospice, is covered through my insurance or not. Palliative care services are similar to seeing any doctor or any physician or getting any kind of help, like home health and all those services that you get at home that are covered through all the insurances. And in addition to that, there would be some kind of a copay which you pay for any physician services. That will be there for palliative care services.
But with regards to hospice, hospice is 100% covered through all the insurances. You need not pay even a single penny out of your pocket as copay for hospice services. And if you do not have even insurance, some, and I would say most of the hospice agencies provide what is called a charity care.
So you need not worry about having bills through your insurance company if you are enrolling in hospice services. It's covered 100%. It's one of those services of Medicare and also of the insurance agencies that is covered 100%.
So the key is to ask questions. If you have any doubts at all, just ask questions of your provider or wherever you're getting your care.
Absolutely. There's no wrong, bad question or a wrong question. You can ask any questions at any time.
Perfect. I do have one final question for each one of you. And I want to talk about what makes our services here at UChicago Medicine, and, of course, UChicago Medicine Ingalls Memorial, what makes our services unique and special? And Dr. Ahmed Khan, I'm going to start with you, if I can.
Sure. So as I was saying about myself, as well all the physicians that are here working in the Hospice and Palliative Care Department at University of Chicago at Hyde Campus and Ingalls Memorial Hospital are specially trained. Basically, they are all fellowship trained in one year of fellowship after their primary specialty. In addition to that, everyone is board certified in hospice and palliative care medicine.
We strive towards excellence. And we have a robust palliative care and hospice training program for the future doctors as well. So not just we are providing the services. We are also training the future doctors who would be providing services to these kinds of patients moving forward. And we have a very strong ancillary support team of the nurses and also the staff, including social workers and chaplains, who work with us closely in the hospital at Hyde Campus, and also at Ingalls Memorial Hospital, and also at our inpatient hospice unit in Harvey, Illinois.
Dr. Quadri, the same question for you.
So being part of any family's final moments of their loved one passing away is always a difficult time for any family. We are always there to support you guys. And we will do anything that we can to help alleviate some of the symptoms and make it as comfortable for the passing person as we can.
And again, I just can't stress how important this is for people to keep this in mind and really seriously consider and look into both palliative care and hospice care, depending on what what's going on in your life or your loved one's life, because it does make a tremendous difference. Again, I've experienced it myself. And I know how valuable it is. And it was just a tremendous difference for my family. So that's basically it for the program. You two were great today.
Thank you so much for inviting us. I really enjoyed the time here.
Fantastic. Very, very happy to have you on. We are out of time. A special thanks to our guests for being with us today. Thank you to those who watched the program. Please remember to check out our Facebook page for our schedule of programs coming up in the future.
To make an appointment, go online at uchicagomedicine.org. Or you can call 888-824-0200. Thanks again for being with us today. And I hope everyone has a great week.