Palliative care vs hospice care—what’s the difference? This is a common question when it comes to end-of-life care and one that we’re here to answer. Many people around the world die each day in nursing homes, hospitals, and other medical care facilities receiving treatment that doesn’t align with their wishes. That’s why many people turn to alternative methods of end-of-life care so that they can make the transition from life to death the way they want to.
However, if you or a loved one chooses in-home care, that doesn’t mean death is inevitable, and that’s where palliative care comes in.
Palliative Care Definition
Palliative care is personalized care for people suffering from a serious illness or medical condition. Many people who choose palliative care are living with a terminal illness, but many others are not. Palliative care, much like hospice care, focuses on symptom and stress relief and improving the patient’s quality of life.
According to Get Palliative Care, palliative care teams “treat people suffering from the symptoms and stress of serious illnesses such as cancer, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), kidney disease, Alzheimer’s, Parkinson’s, Amyotrophic Lateral Sclerosis (ALS) and many more.”
People living with these illnesses experience many symptoms that palliative care teams treat and manage. Symptoms include:
- Mental symptoms such as depression and anxiety
- Physical symptoms such as pain, nausea, fatigue, and trouble breathing
- Struggles with sleep such as hypersomnia or insomnia
A palliative care team is made up of doctors, nurses, and other professionals such as therapists, chaplains, or social workers who specialize in end-of-life care. These specialists will work with the patient, their other doctors, and their family to provide the level of support a patient needs. Palliative care often supplements other curative treatments and is appropriate for patients of any age.
Despite many people receiving palliative care at home, patients can also receive care in nursing homes, hospitals, or outpatient clinics, too. Most Medicare or Medicaid policies will cover care, but it’s best to check how much end-of-life care insurance will cover before starting palliative care.
It should be noted that unlike hospice care, palliative care patients do not have to give up any treatments that might cure their illness, such as chemotherapy, injections, medications, and more. Many patients who receive palliative care live longer because of the combined medical, physical, emotional, and spiritual support this type of care offers.
If palliative care stops working, and an illness becomes terminal, it is possible to transition to some form of hospice care.
Hospice Care Definition
Hospice care is for terminally ill patients or patients who have chosen to forego certain medical treatments. Unlike palliative care, hospice care does not focus on curing a disease or slowing its progress; rather, hospice care provides comfort care and symptom relief until the patient passes away.
Patients can receive hospice care at home, the hospital, a nursing home, an assisted living facility, or a hospice house. Similar to palliative care, a hospice care team consists of doctors, nurses, social workers, chaplains, therapists, and other professionals who help make the patient as comfortable as possible as they transition from life to death.
Most hospice care programs under Medicare offer four levels of care: routine in-home care, 24/7 care, inpatient care, and respite care. Each of these levels can fall under general comfort care, which focuses on pain and symptom management in addition to the quality of life of both the patient and their family.
Routine In-Home Care
Routine in-home care is a part-time or intermittent hospice option, that offers at-home medical supplies, equipment, some medications such as injectable osteoporosis drugs, and part-time nursing or health aide services. The medical professionals on an in-home care team can provide physical or occupational therapy, speech pathology, or any social services that come with the patient’s specific illness. When a member or members of the hospice team aren’t around, it is up to the family to care and provide for the patient.
As illnesses progress, they often require 24/7 care and symptom management. Reasons for the shift from part-time care to 24/7 care include:
- A need for full-time pain management
- Frequent bouts of nausea and vomiting
- Severe trouble breathing
- Mental symptoms such as depression or anxiety, especially when those symptoms lead to frequent panic attacks
- Loss or burnout of the primary caregiver
Inpatient care is exactly what it sounds like. Some patients have severe symptoms that their family can’t handle at home, so they move to an inpatient facility to receive round-the-clock care from nurses and doctors.
While the hospice team cares for the patient and provides much-needed support, it’s often family members and friends who take on most of the caregiving responsibilities, which can lead to caregiver burnout. Respite care is often given for a few hours up to 5-days but can be available for as long as several weeks in some circumstances. Usually, respite care means that the patient moves to a temporary inpatient setting so that the family can rest, travel, attend events, or do whatever they need to do to gain some respite from caregiving.
While there are different levels of hospice care, most hospice teams will have someone available 24/7 should any emergencies arise. It’s also important to note that entering into hospice care does not mean that all treatment will cease. For example, if someone who is receiving chemotherapy has been advised to stop chemo and start hospice care, they can still take medications for things such as high blood pressure or other illnesses unrelated to their terminal illness.
Entering hospice care doesn’t mean that death is right around the corner or that anyone is trying to move a patient’s death along; it just means that a team of medical professionals will work to affirm the patient’s life and make them as comfortable as possible while adhering to their wishes and taking care of their family’s needs, too. In fact, many people suffer through treatments longer than they should because they are not eligible for hospice care right away.
If you’re considering hospice care for yourself or a loved one, here’s what to expect:
- You will meet regularly with the hospice care team to stay updated on your condition and next steps.
- You always have the opportunity to share feelings, emotions, questions, concerns, or any other topics related to the process of dying.
- Most caregivers will update you daily with any pertinent information.
- In the U.S., Medicare requires a prognosis from a healthcare provider that a patient has 6 months or less to live. However, it’s difficult to predict how long someone will live with a terminal illness, so oftentimes, hospice care will extend past six months until the patient’s illness runs its natural course.
Palliative Care vs Hospice Care: What Is The Difference?
While hospice and palliative care both focus on improving a patient’s quality of life through symptom management and relief, they aren’t quite the same. Here’s a breakdown of how they’re different:
|Palliative Care||Hospice Care|
|Palliative care is available for patients at any stage of a serious or terminal illness.||Hospice care is available for patients who are in the last stages of a terminal illness. Most patients can’t receive hospice care until their healthcare provider tells them they have 6 months or less to live.|
|Patients can receive palliative care while they’re undergoing other curative treatments, such as chemotherapy.||Patients receive hospice care when curative treatments stop working. Hospice “treatment” consists of managing and relieving symptoms as much as possible.|
|The palliative care team works separately from any existing care teams, communicating with them to provide symptom management and relief.||Generally, a hospice care team provides the majority of patient care, communicating with any additional medical teams when necessary.|