Are you wondering what the difference is between palliative care and hospice?
When I was a home health and hospice nurse, the medical director made the decision to take on palliative care. However, I had no idea what it was.
I was pleasantly surprised to learn that palliative care bridged the gap between hospice, which is end-of-life care, and clinic visits to the doctor for acute and chronic illnesses in which the symptoms are well managed.
Both palliative care and hospice manage serious illnesses. However, their focus is different.
So, what is the difference between palliative care and hospice care? Is hospice palliative care? Is palliative care hospice?
What Is Palliative Care?
Palliative care is symptom management for patients who have life-threatening or serious illnesses; palliative care is without regard to life expectancy.
Patients can still seek curative treatments when they receive palliative care.
How Does Palliative Care Work?
Many times, after an extended hospital stay, the discharge planner will refer the patient to palliative care.
This level of care provides more intense care and services than a home health referral would.
Referral to palliative care can be made through a hospital discharge planner, the patient themself, family, doctor, and anyone involved in the care of the patient.
For example, if you are discharged from the hospital following a stroke and still struggle with mobility, balance, cognitive function, and pain, your discharge planner could refer you to palliative care.
The palliative care team works alongside your doctors to provide another layer of support through symptom management, pain relief, physical therapy, psychosocial skills, communication with doctors, and help clarify your goals for care.
If your illness progresses to the point that you and your doctor are not seeking a cure, you may be referred to hospice.
How to Pay for Palliative Care
Some types of palliative care are covered by Medicare Part B, Medicaid, and some private insurance. Not all costs are covered. For example, respite services are not covered for palliative care. Check with your insurance for details.
What is Hospice?
Hospice (also known as end-of-life care), like palliative care, focuses on pain and symptom management of serious illnesses and diseases.
However, the stage of illness has progressed so far that life expectancy is only six or fewer months.
Hospice focuses on pain management and comfort care as the disease progresses. It is not focused on curative or life-extending management. Hospice also covers durable medical equipment such as hospital beds, walkers, etc.
Bereavement services are provided for family and caregivers for up to a year after the patient has died.
Hospice’s goal is to focus on quality of life and working with the patient and family to meet end-of-life emotional, spiritual, and spiritual needs and decisions.
How to Pay for Hospice
Hospice is generally covered by Medicare, provided that a doctor has evaluated the care recipient and determined they have six months or less left to live.
How to Transition to Hospice
Hospice care may be appropriate if the disease has progressed beyond seeking a cure and life expectancy is six months or less, according to your doctor.
Referrals to hospice can come from the patient themself, nurse, social worker, family member, or doctor. It is important to implement a hospice referral as soon as possible. The focus shifts from seeking a cure to quality of life and honoring the patient’s wishes.
Patients, family members, and caregivers are given education, and emotional and spiritual support as the disease progresses and the patient’s health declines.
Comfort measures, including pain management, relieving breathing difficulties, bathing, and emotional support, are part of hospice.
Early intervention allows patients, family members, caregivers, and the hospice team time to prepare and be aware of the stages preceding death - time to provide care and address physical, emotional, spiritual, financial, and other needs.
Which Diseases Are Managed by Both Hospice and Palliative Care?
Some of the diseases both hospice and palliative care manage are:
- Cancer
- Diabetes
- Stroke
- COPD
- End-stage renal disease
- MS
- Dementia
- ALS
- Parkinson's
What do Hospice and Palliative Care Have in Common?
Both hospice and palliative care are medical specialties designed to support individuals with serious, long-term illnesses.
Both strive to improve quality of life and increase comfort for the care recipient, and provide emotional support to both the care recipient and their family while helping you with any necessary medical decisions.
Some of the commonalities you can expect from both hospice and palliative care include:
- A team comprised of a medical director, social workers, chaplain, nurses, CNAs, physical therapists, non-family volunteers, and involved family members.
- A holistic approach to patient care.
- Patients are living with a serious illness.
- Pain and symptom management including pain control, relief from breathing difficulties, cognitive decline, anxiety, and depression.
- Nutritional guidance and specialized diet education.
- Medication management.
- Other therapies including physical, occupational, and speech therapy (for swallowing evaluations).
- Spiritual support to help honor and accommodate spiritual practices.
- A social worker to help Identify emotional, spiritual, and financial assistance and refer you as needed.
- Grief support for one year following death.
- Family support including working with the family and caregivers, providing education and counseling.
- Help managing side effects of medications and treatments such as wound care, catheters, breathing equipment, etc.
- Quality of life care, physical, emotional, and spiritual support for the patient and caregiver(s).
- Both palliative care and hospice services can be provided in a variety of settings. From hospitals to assisted living, outpatient, and home settings.
- Assistance with medical forms, living wills, and financial counseling.
How Do Hospice and Palliative Care Differ?
The most significant difference between hospice and palliative is when they become available.
While palliative care does not depend on the stage of the illness, meaning it is generally available immediately after a life threatening diagnosis has been made, hospice care is only available after a doctor has evaluated a life expectancy of six months or less.
The chart below outlines some of the key differences between hospice and palliative care.
Palliative Care | Hospice | |
Who is Eligible to Receive This Type of Care? | Anyone with a serious or chronic illness where the symptoms or treatments are difficult to manage without help. | Anyone with a serious illness that a doctor believes thas six or fewer months to live. |
Is a Referral Required? | No. The patient, family, a doctor, nurse, or social worker, friends, and caregivers can initiate the request. | No. The patient, family, a doctor, nurse, or social worker, friends, and caregivers can initiate the request. |
What Services Are Available? | - Symptom and medication management | - Comfort care, pain, and medication management for symptom relief |
Are Curative Treatments Available? | Yes | No. All curative or life-prolonging treatments must be stopped in order to qualify for hospice. |
Where is Care Provided? | The patient's home, outpatient facilities, nursing home, assisted living, and hospital. | Hospice homes, nursing homes, long-term care facilities, assisted living. If symptoms such as pain or breathing difficulties are uncontrolled, temporary admission to the hospital to stabilize and provide pain relief. |
Who Pays For Care? | Some types of palliative care are covered by Medicare Part B, Medicaid, and some private insurance. Not all costs are covered. VA may cover if a veteran. | Medicare part A, Medicaid, and some insurance companies. Medicare benefits can be renewed multiple times if needed. Medicaid and private insurance may cover hospice. Check with an insurance provider. |
