Palliative Care vs Hospice

Hospice and palliative care are two different types of care that are often confused. Both provide pain and symptom relief for people with serious illness, but there are important differences. Learning more about the difference between hospice and palliative care will help you find the right care for your situation.

When comparing palliative care vs. hospice, it’s useful to know the definitions of each as a starting point.

Hospice Definition

Hospice is defined as care for people in the later stages of serious illness who are expected to live months rather than years. It is sometimes called “end of life” care. People often choose hospice care when treatment is no longer working, or they don’t want to continue treatments to try to cure a terminal disease. Hospice is for people who want to maximize the time they have left, surrounded by what matters most to them.

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It’s important to know that hospice is provided wherever the patient calls home, whether that be their private residence, a family member’s home, a nursing home or other location.

Here are some important facts about the hospice definition:

The focus of hospice care is comfort and quality of life.
Hospice includes palliative care, plus added services.
Hospice services may include regular visits from nurses, nurses’ aides, social workers, chaplains and trained volunteers.
Medicare, Medicaid and most private insurance plans cover hospice costs for qualifying patients.
As long as a physician certifies a person is eligible, hospice care can be extended if necessary. A person can also change their mind about hospice anytime.
Family caregivers get a lot of support while their loved one is receiving hospice care. This may include education, respite care and bereavement support.

Definition of Palliative Care

The definition of palliative care is care that provides relief from symptoms of a serious illness and side effects of treatments. Palliative care is an option before there is a need for hospice. Patients can receive palliative care when they’re first diagnosed with a serious illness. They can also receive care while working toward a cure or transitioning to end-of-life care. With the support of palliative care, patients may be able to feel better, continue working and doing daily activities, and recover.

Here are some important facts about the definition of palliative care:

The main goals of palliative care are helping patients feel better and improving their quality of life.
Palliative care is a consult-based program with nurse practitioners who help patients and families manage chronic illnesses such as cancer, dementia, amyotrophic lateral sclerosis (ALS), and kidney, heart and lung diseases.
Some of the services commonly offered in palliative care are pain and symptom management, goals of care discussions, advanced care planning, family meetings, education and support.
Patients can transition from palliative care to hospice care as their disease progresses toward the end of life.
Some of the professionals that may be on the palliative care team are doctors, nurses, dietitians, social workers and chaplains.
Palliative care helps patients coordinate with their primary care physician, specialists, and community resources to get the right care and support for their complex and chronic health needs.

10 Ways Hospice and Palliative Care are the Same

It’s important to understand the difference between hospice and palliative care, but let’s start with the similarities. Both offer:

Compassionate care for patients with serious illnesses
Pain and symptom relief
Greater independence and control
Fewer unnecessary trips to the hospital
Comfort and quality of life as the primary goals
Physical, emotional and spiritual support
Treatment teams made up of professionals with a variety of special skills
Social and emotional support for family caregivers
Education on health conditions and what to expect during care
Care coordination with the patient’s current primary care doctor/healthcare team

8 Differences Between Hospice and Palliative Care

The most important things to understand about the palliative care vs. hospice definitions are:

1. Start Time

Hospice care begins in the later stages of illness, when the person is expected to live about six months, and is also called end of life care.
Palliative care can start at any stage of an illness. This includes when the person is diagnosed, when they’re receiving treatment to cure their illness or when they’re nearing the end of their life.

2. Goals of Care

When a patient chooses hospice, the goals of care shift from curing illness to focusing on comfort and quality of life.
When a patient chooses palliative care, quality of life and comfort is also key. However, patients can receive palliative care at the same time that they’re trying to cure their illness. Their goal is to recover and/or extend life while staying as comfortable as possible.

3. Payment

Hospice costs are 100% covered by Medicare, Medicaid, the Veterans Administration and most private insurance plans for qualifying patients. Benefits cover the cost of hospice services and medications, as well as medical equipment and supplies related to the terminal illness. Medications and services that are unrelated to the terminal illness fall under the patient’s traditional Medicare, Medicaid or private insurance benefits.
Palliative care costs are usually paid for by insurance or out of pocket by the patient. Some costs may be covered by Medicare, Medicaid or private insurance, depending on the patient’s plan.

4. Frequency

Hospice care involves regular visits from a nurse, certified nurses’ aide and other hospice staff including chaplains, volunteers and more. These visits may happen multiple times per week, depending on the patient’s needs.
Palliative care visits are also dependent on each patient’s needs as they change. In some cases, this can be weekly, monthly or even less frequently.

5. Eligibility

To receive hospice under Medicare, patients have to meet eligibility requirements (prognosis of six months or less as determined by a doctor).
Since Medicare only covers parts of palliative care, patients do not need to meet specific requirements to be eligible.

6. Length of Care

Patients can receive hospice care for six months or longer if a doctor certifies that they continue to meet eligibility criteria.
Palliative care is available starting upon diagnosis and continuing until the patient’s illness is cured or they transition to end-of-life care.

7. Location

Hospice is provided wherever the patient calls home, whether that be a private residence, a nursing home, a hospital or other location. Patients do not have to travel to receive these services.
Palliative care can also be provided at home or in a hospital or facility. In some cases, palliative care is offered through special outpatient clinics, where patients may travel to visit with palliative care providers.

8. Support

Hospice services include some in-home care, such as nursing care, a certified nurse’s assistant who can help with activities of daily living and other support.
Palliative care may include nursing visits but focuses heavily on advanced care planning and care coordination, helping patients to work with resources available to them to receive additional support in the home.

Although there are many differences between hospice and palliative care, both types of care can make a difficult time easier for patients and their families. If you’re struggling with a serious illness, ask your health care provider which is the best option for you, palliative vs. hospice. To learn more, call a care center near you.