What is the Difference Between Palliative Care and Hospice?

Diane Carbo

Oct 27, 2023 • 30 min read

Palliative care and hospice are two important kinds of care available for people with serious illnesses.

Introduction

Palliative care and hospice are two important kinds of care available for people with serious illnesses. Both involve treating symptoms and providing emotional and spiritual support, but they have some key differences. This guide will explain what palliative care and hospice are, the major differences between them, and why it's important to understand them.

What is Hospice Care?

Hospice care is a specialized form of care designed to help individuals and families facing a life-limiting illness. The primary goals of hospice are to provide comfort and support, preserve dignity, and improve quality of life for those facing the end of life. Hospice care focuses on alleviating pain and providing psychological, social, and spiritual support.

Hospice care is provided by an interdisciplinary team of professionals, including physicians, nurses, social workers, chaplains, and trained volunteers. This team provides physical, emotional, and spiritual support to both the patient and their family members.

Definition of Palliative Care

Palliative care is specialized medical care designed to relieve the physical, psychological, social, and spiritual symptoms of serious illnesses, with the goal of improving quality of life for both the patient and family. It is often provided alongside curative treatments in an effort to improve the overall experience of serious illness and reduce suffering. Palliative care is provided by an interdisciplinary team of healthcare professionals, including doctors, nurses, social workers, counselors, and other specialists.

The primary goals of palliative care are to minimize pain, provide emotional and spiritual support, help patients understand their options, and ensure that their wishes for end-of-life care are respected. In addition to relieving pain and other physical symptoms, such as loss of appetite or nausea, palliative care also includes psychological, social, and spiritual support. This can include counseling, help with advance care planning, or access to spiritual advisors. Palliative care is typically provided in the patient's home, but can also be provided in a hospital setting.

Primary Differences Between Hospice and Palliative Care

Palliative care and hospice care both aim to meet the needs of someone in the last stages of life, but there are some key differences between the two types of care.

Who provides care is one of the primary differences between hospice care and palliative care. Hospice care is administered by a certified hospice agency or team, while palliative care is usually provided by a multidisciplinary team in a hospital setting, such as a family doctor, specialist, nurse, and social worker.

When care is provided is also different for each type. Hospice care is available at any stage of an illness, while palliative care is generally provided when a cure is no longer possible.

The types of treatments available from hospice care and palliative care also vary. Generally, hospice care focuses on providing comfort and support for physical and emotional symptoms, as well as spiritual care. Palliative care may also include curative treatments for pain and other symptoms that could potentially improve quality of life.

Who Qualifies for Care?

If you're considering hospice or palliative care, it's important to know who qualifies for such care. Depending on your individual circumstances, you may qualify for one type of care or both.

In order to qualify for hospice care, you must have a life expectancy of six months or less if the disease follows its normal course. Hospice care is typically only available when all curative treatments are no longer effective. This means that you must agree to forego further medical treatments in order to qualify. Additionally, patients must be referred to a hospice program by their doctor and have a caregiver or family member who can help with the care.

Palliative care, on the other hand, can be used alongside curative treatments, and is available to people with any diagnosis. Unlike hospice, palliative care does not have a time limit. Patients are referred to palliative care programs by their doctors, and can start receiving care at any stage of their illness.

Common Symptoms

Palliative care and hospice care both provide specialized care to people with serious illnesses. While both types of care address physical symptoms, they also seek to address psychological and spiritual concerns. Common physical symptoms addressed by both palliative and hospice care include pain management, shortness of breath, nausea, and loss of appetite. Psychological symptoms such as anxiety, depression, and fear may also be addressed through counseling and other supportive services.

In addition to addressing physical and psychological symptoms, palliative and hospice care also provide spiritual and emotional support. This includes providing emotional comfort and support to family members, helping the patient face difficult diagnoses, and offering religious support and spiritual guidance. Treatment for these types of symptoms is tailored to the individual and may include prayer, spiritual direction, and other forms of spiritual care.

Benefits and Risks of Palliative Care and Hospice

The decision to choose palliative care or hospice is an important one and should be made with careful consideration. There are a variety of benefits and risks associated with each option that must be taken into account.

Palliative care can help improve quality of life by relieving pain and offering support services such as spiritual guidance, emotional and psychological counseling, and social work services. It also allows patients to remain in their own homes while still receiving necessary medical care. The main risk associated with palliative care is that it does not cure the underlying condition, but rather seeks to make the patient comfortable.

Hospice care is specialized end-of-life care that focuses on providing comfort and quality of life until death. The main benefit of hospice is that it allows patients to die with dignity in a familiar setting, surrounded by family and friends. It also offers emotional and spiritual support for patients and their families. The main risk associated with hospice is that it may limit access to certain treatments if they are deemed not to provide comfort or be helpful for quality of life.

Advanced Care Planning

Advanced care planning is the process of making decisions about medical care for a person in the event that they become too ill to make these decisions themselves. Advanced care planning requires working closely with a doctor and/or other health care professional, and deciding what treatments the person prefers. It is important to understand the differences between hospice and palliative care when planning advanced care.

For hospice patients, advanced care planning should include discussions about whether or not the patient wishes to receive life-sustaining treatments, such as ventilator or dialysis treatments, or if interventions like pain relief medications are preferred. It is also important to discuss end of life issues, such as funeral arrangements and any spiritual concerns. For palliative care, advanced care planning should involve conversations about symptoms and treatment goals, as well as preferences for location of care (e.g., at home or in a hospital). It is also important to discuss any ethical concerns that the patient may have.

Pros and Cons of Palliative Care vs Hospice

When it comes to choosing between palliative care and hospice, it is important to understand the different advantages and disadvantages that each type of care provides. Palliative care may offer more symptom relief and the potential for improved quality of life, while hospice provides emotional and spiritual support. Here is a look at the pros and cons of both types of care:

Pros of Palliative Care

Focuses on managing physical symptoms
May provide some psychological and social benefits
Provides an individualized treatment plan that is adapted to meet changing needs

Cons of Palliative Care

May not be covered under insurance plans
May not be able to treat advanced or terminal illnesses effectively
May require frequent hospital visits

Pros of Hospice

Provides comprehensive care and emotional support
Care is tailored to meet the individual's particular needs
Hospice care can be provided in a variety of settings, including inpatient, home care, and outpatient

Cons of Hospice

May require individuals to give up potentially beneficial treatments
May cause individuals to feel like they are giving up hope
May be limited in its ability to treat symptoms such as pain or discomfort

Cost of Palliative Care vs Hospice

The cost of palliative or hospice care depends on the type of service provided, the length of time needed, and the facility providing the care. Both hospice and palliative care can be expensive, especially if the care is in an inpatient facility. In addition, both kinds of care may require payment of out-of-pocket fees.

Hospice care is less expensive than palliative care because it typically covers more services such as counseling, medications and familiar items. Because hospice care is usually covered by Medicare, Medicaid and some private insurances, the cost is often much lower than palliative care.

Palliative care, on the other hand, is usually provided on an outpatient basis and generally has higher associated costs. The expenses may include medical treatments, medications, equipment, doctor visits, and home health aides. Private insurance companies may not cover this type of care so patients may be responsible for paying out-of-pocket costs.

It is important to note that both types of care may provide financial assistance or help with medical expenses. Depending on the type of program and individual circumstances, some patients may be eligible for assistance with payments.

Choosing the Right Care:

Deciding which type of care is right for you or your loved one can be a difficult process. Here are some tips to help you make the best decision for your situation:

Understand your goals. Ask yourself what kind of life you or your loved one wants to live. Do you want to focus on symptom relief and comfort or find a cure?
Communicate with your doctor. Talking openly with your doctor about your options helps ensure you make an informed decision. Be sure to ask questions and bring up any concerns you have.
Gather information about costs. Both palliative care and hospice come with costs, so understanding the associated financial impacts is important.
Consider your support system. Talk to those around you to get their opinion on what type of care would be best for you or your loved one. Having a strong support system can be invaluable during this process.
Discuss your concerns with your care team. Speak to members of your care team, including your doctor, nurse, social worker, and palliative care team, to get more information about these two types of care.
Trust your instincts. Ultimately, trust your instincts and follow your heart when it comes to the care you or your loved one receives.

Palliative care and hospice both offer end-of-life care that improves quality of life for those who are terminally ill. Knowing the differences between these two care programs can help individuals make informed decisions about which type of care is the best option for them. This guide outlines the key differences between palliative care and hospice, along with information on who qualifies for each type of care, how to access it, and the benefits and risks associated with each.

The primary difference between palliative care and hospice is the stage of illness required to receive each type of care. Palliative care is available earlier in an illness and is aimed at improving quality of life and comfort for people who are seriously ill, while hospice is typically reserved for people who have a short life expectancy and are no longer responding to treatment. It is important to note that palliative care and hospice are not mutually exclusive and can be used in conjunction with each other.

Palliative care is provided by a team of health care professionals including doctors, nurses, social workers, and other specialists. This team works together to provide both physical and emotional support to patients and their families. Common symptoms treated with palliative care include pain, nausea, and fatigue. Palliative care can also provide spiritual and psychological support such as counselling and grief therapy.

Hospice care is mainly provided by a team of trained volunteers and family members. Hospice is focused on providing comfort and support during the last stages of life and often includes activities such as music therapy and art therapy. Common symptoms treated with hospice care include pain, shortness of breath, and anxiety.

When making decisions about which type of care is best for a patient, it is important to weigh the potential benefits and risks of each type of care. Palliative care can help improve quality of life for those living with a serious illness, while hospice can provide comfort and support during the last stages of life. However, it is important to understand that palliative care and hospice both come with associated costs and should be discussed with a physician or health care provider.

For more information on palliative care and hospice, it is important to speak with a medical professional or look for resources from reputable organizations such as the National Hospice and Palliative Care Organization.