To palliate means to make comfortable by treating a person's symptoms from an illness. Hospice and palliative care both focus on helping a person be comfortable by addressing issues causing physical or emotional pain, or suffering. Hospice and other palliative care providers have teams of people working together to provide care. The goals of palliative care are to improve the quality of a seriously ill person's life and to support that person and their family during and after treatment.

Hospice focuses on relieving symptoms and supporting patients with a life expectancy of months, not years, and their families. However, palliative care may be given at any time during a patient's illness; from the initial diagnosis. Most hospices have a set of defined services, team members, and rules and regulations. Some hospices provide palliative care as a separate program or service, which can be very confusing to patients and families.

The list of questions below provides answers to common questions about the difference between hospice and palliative care.

Who can benefit from Palliative Medicine?

Patients with life-limiting illnesses, including, but not limited to:

• Metastatic or recurrent cancer
• Dementia
• Liver disease
• COPD
• HIV/AIDS
• Cardiac disease
• Stroke
• Renal disease
• Persistent coma

Patients with uncontrolled physical symptoms, including, but not limited to:

• Pain
• Delirium
• Dyspnea (shortness of breath)
• Insomnia
• Nausea (and/or vomiting)
• Anxiety
• Agitation
• Cough
• Patients and/or families wishing to discuss:
• Advance care planning
• Goals of therapy
• Comfort-directed therapy
• Withdrawal of mechanical ventilation, artificial nutrition, and/or other forms of artificial life support

Who can receive this care?   Anyone with a serious illness, regardless of life expectancy, can receive palliative care   Someone with an illness with a life expectancy measured in months not years Can I continue to receive treatments to cure my illness?   You may receive palliative care and curative care at the same time   Treatments and medicines aimed at relieving symptoms are provided by hospice Does Medicare pay?   Some treatments and medications may be covered   Medicare pays all charges related to hospice Does Medicaid pay?   Some treatments and medications may be covered   In 47 states, Medicaid pays all charges related to hospice Does private insurance pay?   Some treatments and medications may be covered   Most insurance plans have a hospice benefit Is this a package deal?   No, there is no 'palliative care' package, the services are flexible and based on the patient's needs   Medicare and Medicaid hospice benefits are package deals How long can I receive care?   This will depend upon your care needs, and the coverage you have through Medicare, Medicaid or private insurance   As long as you meet the hospice's criteria of an illness with a life expectancy of months not years What organization provides these services?     Hospitals Hospices Nursing Facilities Health Care Clinics   Hospice organizations Hospice programs based out of a hospital Other health care organizations Where are services provided?             Home Assisted living facility Nursing facility Hospital   Usually, wherever the patient resides, in their home, assisted living facility, nursing facility, or hospital. Some hospices have facilities where people can live, like a hospice residence, or receive care for short-term reasons, such as acute pain or symptom management. Who provides these services?   It varies. However usually there is a team including doctors, nurses, social workers and chaplains, similar to the hospice team.   A team - doctor, nurse, social worker, chaplain, volunteer, home health aide and others. Do they offer expert end-of-life care?   This varies, be sure to ask   Yes, staff are experts in end-of-life care

Back To Top

How can you make referrals for Palliative Medicine?

All referrals must come from the patient's physician. Contact Monica Stevens at 540/536-5013 between 8:30 am to 4:30 p.m. If you have reached us after hours, please leave a message and we will return your call the next business day.

Meet The Team

Dr. Mai Amy Ha, MD	1997 – Graduate of SABA University Medical School, Netherlands-Antilles 1997- 2000 - Internal Medicine Residency – Hahnemann University Hospitals – MCP, Pennsylvania 2000-2001 Geriatrics Fellowship - University of Miami, Florida 2001-2003 – Assistant Medical Director/Assistant Professor at University of Miami/Veterans Affairs Medical Center Home Based Primary Care Program 2004 – Present Blue Ridge Hospice 2005 Named Medical Director at Blue Ridge Hospice Board Certified in Internal Medicine, Geriatrics, Hospice and Palliative Care Full staff privileges at Winchester Medical Center and Courtesy staff privileges at Shenandoah Memorial Hospital
Jack Wright, MD	1982 – Graduate of University of Virginia Medical School 1982 – 1985 -  Internship/Residency at Womack Army Hospital, Fort Bragg, NC in Family Medicine 1985 - Board certified and credentialed in Family Medicine 2008 - Board Certified and credentialed in Hospice and Palliative Medicine 2009 to Present – Blue Ridge Hospice Practiced in the Army for six years post residency, then civilian for eighteen years (Harrisonburg, VA), Volunteer medical director with Rockingham Memorial Hospital Hospice for fourteen years Full staff privileges at Winchester Medical Center
Gina Caudill, LCSW-C	1979 – Graduate of University of Missouri-Columbia - BSW 1980 – Graduate of University of Missouri-Columbia - MSW 1982 -  Member of Academy of Certified Social Workers 2005 – 2009  Blue Ridge Hospice  - Social Work Case Manager 2009 to Present – Blue Ridge Hospice – Manager of Counseling Services.
Jennifer Martin, RN, CHPN	1989-1990 - Student Nurse with Amherst Family Practice 1991 - Graduate of Shenandoah University School of Nursing 1991-1994 - RN Winchester Medical Center, Oncology Unit 1994-1995 - RN Case Manager / PRN Nurse with Blue Ridge Hospice 1995-1996 - RN with Amherst Family Practice and Selma Medical 1996-1999 - RN with Shenandoah Oncology Associates 1999 to Present: RN Case Manager, Intake/Assessment RN, RN Liaison/RN Clinical Manager RN (Blue Ridge Hospice) 2007 - Obtained Certification in Hospice and Palliative Medicine
Rachel Schwartz, LCSW	1991 – Graduate of Oberlin College – Oberlin, Ohio 1993 – Graduate of University of Maryland at Baltimore – MSW 1993-2006 – Employed as a Social Worker at various community based organizations with a focus on mental health 1997 – Received LCSW Licensing – State of Virginia 2006 to Present – Blue Ridge Hospice

Back To Top

End-Of-Life Planning Tools

• Have an advance directive (PDF/23.6k) in place that authorizes a person of your choosing to make decisions if you become unable to do so for yourself.
  
  
• Draw up a living will of instructions (PDF/23.6k) to make known what you want done if, for example, you are seriously ill and the only way you can be kept alive is by artificial means.
  
  
• Encourage your family and loved ones to complete their own advance directive. (PDF/24k)
  
  
• Get the information you need about services provided by Blue Ridge Hospice.
  
  
• Discuss your thoughts, concerns and choices with your family and friends.
  
  
• Talk to your health care agent, family and doctor about your choices.
  
  
• Engage others in discussions about end-of-life care issues and encourage them to complete their own advance directives.
  
  
• Seek out opportunities to help others who are dealing with end-of-life care issues such as volunteering with a local hospice or end-of-life care coalition.
  
  
• For more information about Palliative Medicine, please contact Monica Stevens at mstevens@blueridgehospice.org or (540) 536-5013.

For more information, please visit the Center to Advance Palliative Care and the National Consensus Project.

Back to Top