EPISODE 41 – Palliative Care: The Bridge Between Home Health and Hospice

Episode 41 – Palliative Care: The Bridge Between Home Health and Hospice

Many people hear the term palliative care and immediately assume it means hospice—or end of life. In reality, palliative care is often the missing link between home health and hospice, designed to improve quality of life while patients continue active treatment and symptom management.

In this episode of the Team Senior Podcast, Jamie Callahan sits down with Heather Childers, RN (Territory Operations Director) and Shirley Anderson from Accent Home Health to break down what palliative care truly is, who it’s for, and how it can support individuals living with serious or chronic conditions.

You’ll learn:

• What palliative care is—and how it differs from home health and hospice
• When palliative care is appropriate (and when it’s not)
• How palliative care helps manage pain, symptoms, and emotional stress
• Why palliative care can significantly improve quality of life without giving up treatments like dialysis or chemotherapy
• How families and patients can access palliative care through hospitals, doctors, or home health agencies
• What makes Accent Home Health’s CHAP-certified palliative care program unique in Southern Oregon

This episode is especially helpful for seniors, caregivers, veterans, and families navigating complex medical decisions who want support without feeling like they are “at the end.”

📞 To learn more about palliative care services through Accent Home Health:
Call 541-414-1800

At Team Senior™, our mission is to guide you and support you through the maze of Southern Oregon Long-Term Care.

📞 For Team Senior resources, call: 541-295-8230

Or visit our website for more information: https://www.teamsenior.org/

Transcript

Episode 41: Palliative Care - The Bridge Between Home Health and Hospice

Host: Jamie Callahan
Guests: Heather Childers (RN, Territory Operations Director) and Shirley Anderson, Accent Home Health

JAMIE CALLAHAN: Hi, this is Jamie Callahan with the Team Senior Podcast. Our goal is to simplify aging. Society grooms us to plan for retirement, but what about life beyond retirement, where the rubber meets the road? Perhaps you've had a stroke, or you've been diagnosed with cancer, or maybe you're forgetting things and now you have dementia. That's our area of expertise, and we are here to share our insight.

And now, the Team Senior Podcast.

Hi, this is Jamie, and we are in the studio today with Heather and Shirley. They are both from Accent Home Health. Heather, I'm going to give it over to you to introduce yourself and a little bit about Accent.

HEATHER CHILDERS: My name is Heather Childers. I am an RN. I'm the Territory Operations Director with Accent Care Home Health. We provide in-home care services for people in the area. And those care services include nursing, physical therapy, occupational therapy, speech therapy, social work, and we do have a bathing aide.

JAMIE: And you also have behavioral health.

HEATHER: We have behavioral health.

JAMIE: Okay.

HEATHER: Correct.

JAMIE: Yes. Okay. So talk us through—because we want to talk about palliative care today and how palliative care differs from home health and differs from hospice. It's the bridge between the two.

HEATHER: Correct.

JAMIE: Explain to us, to start with, what is palliative care?

HEATHER: Palliative care, just like you said, is the bridge between home health and hospice. It is when you are not ready for hospice yet, but your chronic condition, your ongoing symptom management—so not necessarily that you're going to get better, but it's chronic, and we teach you about the signs and symptoms for you to manage that chronic condition. So it's the in-between home health because in home health, we want you to get better. We want you to graduate off our services. And then with hospice, you can still graduate off the services, but for the most part, with hospice, it's the end of life. So we're the in-between. The palliative care program is the in-between.

JAMIE: So let me—this is how I understand it. Home health is where you're getting physical therapy because you want to get stronger, you want to be able to do more, go more places, do all of those things. Hospice is when we know that death is essentially imminent, right? It's going to happen sometime in the next six to 12 months. There are those cases where when you're on hospice, you suddenly get better and maybe you don't need or want hospice anymore, and so you can graduate off of hospice. But palliative care—and I want to use this example and just have you guys help me understand if palliative would have or could have been appropriate in this scenario. So I had been working with a veteran who—he was a gunner on a helicopter in Vietnam. He jumped out of the helicopter, collapsed several discs in his back. He was terribly depressed because he could not manage his pain. And he also was a little bit like pleasantly confused, so he wasn't always taking his medication.

HEATHER: Exactly.

JAMIE: We helped him get established with caregiving in the home, but at that point, the VA was not comfortable giving him any pain medication because they believed that he had run out too early a couple of times. We believed that he wasn't ready for hospice, and that was confirmed. His diagnosis, prognosis did not warrant going on hospice. But we also believed that if he could manage his pain, the quality of his life would improve a hundredfold. And so we asked for the VA to put in a referral to palliative care. Would that have been appropriate in this scenario?

HEATHER: Yes.

JAMIE: Okay. That's what I thought. So I feel like palliative is a way to improve the quality of your life where you're not ready to say "I'm in the last six to 12 months," but I'm also not willing to do the physical therapy, occupational therapy, all of those things.

HEATHER: Very true.

JAMIE: So how does somebody know? Are they talking with their doctor? Are they talking with the hospital? How do you guys get your referrals for palliative care?

HEATHER: So we get our referrals from both the hospital and the doctor's office. We do have our current patients that we transition to the palliative care program as well.

JAMIE: So they're with you for home health, and then you transition them to palliative care?

HEATHER: Correct.

JAMIE: That's brilliant. I love that. Is there any time when palliative is not appropriate?

HEATHER: Of course.

JAMIE: Okay. There are.

HEATHER: So when the patients—it's a lot of it is the patient's goals as well. If the patient is not ready for end of life, to hear about all of their signs and symptoms, to—if they're really gung-ho about getting better and having all of those therapy services, because a lot of it is the therapy services with home health, that will not qualify them for palliative care.

JAMIE: Okay. I understand that.

SHIRLEY: In addition, I might add that it's appropriate for people to be on palliative care when they are in those—they're headed towards the last stage of life, and doctors might be thinking, or hospice might be thinking, that they're appropriate for hospice, but the patient's not psychologically ready, or their family is not psychologically ready for that. So one of the things that being on palliative care can do for people is it gives them that opportunity to have some counseling while they're on it that can help prepare them for what comes next.

HEATHER: So it's a serious condition, like a chronic illness, symptom burdens that make the patient really uncomfortable. It's not just a terminal status.

JAMIE: Correct. Okay. Tell us a little bit about what services come with palliative care.

HEATHER: So palliative care, you have nursing services, you have social work services. And then if needed, the social work will help set up chaplain services and different therapy services. We have a couple of social workers, and they've done an amazing job with setting up all those alternative services. So I know Shirley, who's here with us today, has set up some crazy different—to us—chaplains and pastors that have come out. And so it doesn't matter what your faith is, there are services in the area that can help.

JAMIE: Okay, so you're getting some of the services that you would get on hospice, but you're not forfeiting your dialysis and things like that.

HEATHER: Correct.

JAMIE: Correct. Okay. That's a really great explanation.

HEATHER: Yep. You can still go to chemotherapy, you can still have dialysis, you can still have all of those services. Unlike when you go to hospice—you may not have those services because hospice pays for all of your medications. It's just a different—it's a different service line.

SHIRLEY: Sure. You can have physical therapy while you're on palliative care to help maintain your strength and balance.

HEATHER: Correct.

JAMIE: Understood. Okay, so when your palliative team comes in, I am very curious to know, given that you can still manage your pain at a higher level and you might be able to—and several other things on palliative care—how many people execute palliative care through the end of life rather than hospice?

SHIRLEY: There's some.

JAMIE: I would imagine there is.

SHIRLEY: That do not want to go to hospice, or their family is resistant to going to hospice, so they stay on home health right up until the end.

JAMIE: What do you want folks to know about it that we haven't already talked about?

HEATHER: So our palliative care program is CHAP-certified. It's the only one in the valley that is CHAP-certified. You can have palliative care through home health, like we do, or you can have it through hospice. I know that there's other programs through hospice that have a palliative care program.

JAMIE: What is the certification?

HEATHER: So the certification—we went through rigorous chart audits. All of our staff were 100% trained on what palliative care is, and we actually had an auditor come out, and we did a week-long audit to make sure that our program met the qualifications and that all of our clinicians are doing what they're supposed to be doing. Every three years, we will have this audit again to make sure that we remain certified.

SHIRLEY: Okay. In addition to that, we also have a physician that oversees our program and attends our palliative care staffing once a week. So he advises us. We report on how patients are doing. He will give us his input, maybe provides suggestions on what we could be doing for them, things we could be talking to their physicians about. So we have that as an added resource as well.

JAMIE: That's a really powerful takeaway. So it is important for folks to know that this program isn't being managed by administrative staff. There is a doctor that's overseeing the program.

HEATHER: Correct.

JAMIE: I know from experience that palliative care and hospice care can radically change or improve the quality of someone's life. Can you guys give me an example of someone that's been on palliative care where their quality of life has improved?

SHIRLEY: Sure. One of the things we'll do is bring equipment into their home or help them acquire equipment. So recently I had a patient I was working with that—he'd basically gotten to a point in his life where he was comfortable in his recliner chair. He couldn't get out of his recliner chair on his own. His wife couldn't help him get out of the recliner chair on his own. So over several visits, because they were not open to the idea at first, we helped bring a hospital-style bed into their home that they put in the living room, helped him get in it. He's more comfortable. It's easier for people to help him in and out of it. He's got his TV right there. We noticed a change in his mood level just with that one little change.

JAMIE: I bet. Yeah. That can really speak volumes, just having the assists at home to make your time at home more pleasurable. All right, I want to say thank you both for being here, and I want to give you an opportunity to please share with our listeners how they get in touch with you.

HEATHER: So you can just give us a call. Our phone number is 541-414-1800, and we are happy to help with any questions, and we can help get you set up with our palliative care services.

JAMIE: Yes. And again, it's 541-414-1800. And I really want to encourage you to reach out to Accent. They have a beautiful set of services that they offer you. It's more services than other home health agencies offer in Southern Oregon. And so it's a really great kind of one-stop shop. Thank you, everyone, for listening.

HEATHER: Thank you.

SHIRLEY: Thank you.

JAMIE: Thank you for listening to the Team Senior Podcast. We're here every week sharing new and relevant information. Remember that we're just a phone call away. Team Senior can be reached at 541-295-8230. Again, 541-295-8230. Until next time, this is Jamie Callahan.

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