Palliative Wound Care for Hospice Patients

Compassionate wound management focused on comfort, dignity, and symptom control for end-of-life care.

Specialized Palliative Wound Care

Hospice patients with wounds require a fundamentally different approach than curative care. Healix360 provides specialized palliative wound management focused on comfort, odor control, pain management, and maintaining dignity—not necessarily achieving closure. Our specialists understand that quality of life, not wound healing, is the primary goal. We work sensitively with hospice teams, patients, and families to provide compassionate care that respects the patient's wishes and hospice philosophy.

Palliative vs Curative Care

Palliative wound care prioritizes comfort over healing. Goals shift from "close the wound" to "control pain, manage odor, prevent infection complications, and maintain patient dignity." Treatment decisions respect patient preferences and life expectancy.

Primary Goals:

  • ✓ Pain and discomfort minimization
  • ✓ Odor control
  • ✓ Exudate management

Secondary Goals:

  • ✓ Prevent wound expansion when possible
  • ✓ Control bleeding
  • ✓ Maintain skin integrity

Common Hospice Wound Scenarios

Terminal Pressure Ulcers (Kennedy Terminal Ulcers)

Unavoidable pressure ulcers that develop in final weeks of life despite appropriate prevention. Often appear suddenly on sacrum, heels, or other bony prominences. Characterized by rapid deterioration and pear or butterfly shape. Focus on comfort, not aggressive treatment.

Our approach: Gentle dressing changes, moisture management, pressure relief, pain control

Fungating Malignant Wounds

Tumors that break through skin creating open wounds, often with necrotic tissue, heavy drainage, and significant odor. Seen in advanced breast, head/neck, and skin cancers. Challenging to manage but symptom control is achievable.

Our approach: Odor control dressings (charcoal, metronidazole), absorbent dressings, gentle debridement if indicated, bleeding management

Diabetic/Vascular Ulcers in Terminal Patients

Pre-existing chronic wounds in patients transitioning to hospice. Goals shift from healing to comfort. May choose less aggressive dressing change frequency to minimize disruption and pain.

Our approach: Simplified dressing regimens, longer wear-time dressings, infection prevention, family/caregiver training

Surgical Wound Dehiscence

Post-operative wounds that opened after surgery in hospice-eligible patients. Closure unlikely given prognosis. Focus on preventing evisceration and maintaining integrity.

Our approach: Protective dressings, abdominal binders if appropriate, monitoring for complications

Palliative Wound Care Strategies

Pain Management

Pre-medicate before dressing changes. Use non-adherent dressings to minimize trauma. Coordinate pain medication timing with hospice team. Consider topical lidocaine for painful wounds.

Odor Control

Charcoal dressings absorb odor. Metronidazole gel topically reduces odor-causing bacteria. Room deodorizers and essential oils can help. Proper wound cleaning prevents odor buildup.

Exudate Management

Highly absorbent foam or superabsorbent dressings control drainage. Less frequent changes (2-3 days instead of daily) reduce patient burden. Skin protection with barrier creams prevents maceration.

Bleeding Control

Non-adherent dressings prevent bleeding during changes. Hemostatic dressings for friable tumor wounds. Dark towels/linens to minimize visual impact of bleeding for patient/family.

Working with Hospice Teams

We deeply respect the hospice philosophy and integrate seamlessly with hospice interdisciplinary teams. Our specialists attend IDG meetings when requested, coordinate care plans with hospice nurses, respect DNR and comfort-care-only directives, communicate regularly with hospice medical directors, and train family members or hospice aides in dressing changes when appropriate. We never recommend treatments that conflict with hospice goals or patient/family wishes.

When Hospice Patients Need Specialist Care

  • Wounds with severe odor that standard dressings can't control, affecting patient/family quality of life
  • Heavy exudate requiring multiple daily dressing changes, disrupting patient rest
  • Fungating tumors requiring specialized dressing expertise
  • Wound pain not controlled by current regimen
  • Gentle debridement needed for comfort but beyond hospice RN scope

Medicare Hospice Benefit Coverage

Under Medicare hospice benefit, wound care must be related to the hospice diagnosis to be covered by hospice. Wound care unrelated to terminal diagnosis may be covered under Medicare Part B separately. We navigate these complex coverage rules and coordinate billing appropriately—hospice is never charged. For hospice-related wounds, we coordinate with hospice for supply coverage. For unrelated wounds (pre-existing diabetic ulcers, etc.), we bill Part B directly.

Compassionate Wound Care When It Matters Most

Contact us to discuss palliative wound care support for your hospice patients.