Hospice vs. Palliative Care
How do you decide between finding hospice or palliative care for your loved one? Learn more about the difference between hospice and palliative care here.
Though both aim to alleviate a patient’s suffering, hospice and palliative care do have some distinctions. It is easier to imagine the two as a pair of nesting dolls–within the large doll of palliative care, nested inside is hospice.
However, for those distinguishing when to use either form of care, hospice care provides all-encompassing symptom management for patients at the end of life, while palliative care can happen at any time in conjunction with curative treatment.
Both of these focus on managing the physical, emotional, and spiritual discomfort of the patient, in addition to providing support for families and caregivers.
The goal of palliative care is to improve quality of life and minimize suffering. For someone with a chronic or complex disease, palliative care can be helpful at the end of life or at any time. It is flexible and has no time restrictions.
On the other hand, hospice care requires a terminal diagnosis and can only be administered when someone no longer receives curative treatment. Transitioning to hospice care can relieve stress on both the patient and the caregiver.
As a caregiver, family member, friend, partner, or spouse of someone who is suffering, understanding how hospice or palliative care can help is like seeing a weight lift off their loved one.
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What is Palliative Care?
The word palliative comes from the word palliate, which means “to ease.” When keeping that in mind, it can be easier to understand palliative care as patient-focused, aiming to alleviate discomfort and improve quality of life. Palliative care can start as soon as a patient decides they need more support while they receive curative treatment for a serious illness.
For example, anyone with Parkinson’s, ALS, kidney failure, cancer, or dementia would benefit from receiving palliative care. But it isn’t just limited to serious illnesses. Palliative care can also cover some more well-known experiences such as appendicitis. The point is that palliative care exists as the non-curative form of treatment focused on making life easier for a patient and their support network at any time.
It is also an all-encompassing form of care where many kinds of staff members across the physical, emotional, and spiritual spectrums come together to bolster families and patients. In most cases it tends to take place in the hospital, but can be administered in any setting such as a private residence or nursing home. More often than not, you’ll see the following professionals working in the palliative care space:
- Nurses helping with pain management and any other illness-related symptoms
- Social workers coordinating care with all providers, updating them on any evolving care goals, and advocating for a patient
- Chaplains providing spiritual support such as religious visits
- Therapists counseling caregivers and patients
- And loads more
As of now, palliative care is not a defined benefit, meaning that you can get insurance coverage with some copays required. If your doctor or any other healthcare provider determines that you need palliative care, Medicare can cover those expenses. It’s worth asking about what kinds of programs exist regardless of how you’re feeling, just to know what’s out there.
What is Hospice Care?
Hospice care is another form of comforting care for a patient with a serious disease, but at a different stage in their illness. Similarly to palliative care, hospice helps patients to manage their pain and adjacent emotional and spiritual issues related to their illness–just at a different time. Imagine palliative care as starting whenever a patient is in need of non-curative support, and hospice carrying that approach to the very end.
In more concrete terms, hospice replaces the goal of curing a disease to prioritize a patient’s comfort and quality of life in their last six months. Primarily, hospice staffers work to support patients and families on physical, emotional, and spiritual levels to ease the transition from life to death. This runs the gamut from pain management, aid for personal care, medication delivery, grief coaching, to even music therapy.
It is also created precisely for the last period in someone’s life, and is covered by insurance as such. Anyone with medical insurance–including Medicaid, Medicare, and Medicare Advantage–can receive hospice care and bereavement therapy at no cost.
In order to gain access to hospice, a physician must officially certify that a patient has a life expectancy of six months or less and is not seeking or receiving curative treatment for their condition.
With that said, a patient does not need to be in a hospital in order to receive hospice care. People can access hospice care from any place they call home; it can be a nursing home, a private residence, or even at a dedicated inpatient hospice facility.
When Should Someone Be Offered Hospice Care?
Long story short, there’s no right answer regarding when to offer hospice care. Only 50 percent of qualifying patients choose hospice, and those that have wished they had started hospice sooner, and the results for those are obvious. Families reported that the weekly nursing and aide support alongside learning about the dying process helped reduce stress and improve the quality of time they have with one another.
While people may think of receiving hospice care as being days or weeks away from dying, the truth is far from it. No one knows when they might die, and even those who receive hospice care may improve–enabling them to “revoke hospice.” Traditionally, hospice care is offered for a six month period to cover any number of treatments and transitions to allow a patient to die with comfort and ease.
There is no definitive checklist for meeting the conditions for hospice care, but here are some things to watch out for:
- When treatment is no longer effective in curing the illness or disease
- The patient wants to discontinue doctor’s visits and no longer receive curative treatment
- Symptoms become too challenging to manage
- Physical and/or cognitive function declines quickly, requiring daily or weekly help
- Appetite and thirst are declining
- The patient is sleeping more
- A caregiver requires significant professional support to keep a loved one comfortable and pain-free.
When Should Someone Be Offered Palliative Care?
Again, like with hospice care–there is no definitive point for when someone should be offered palliative care. But a patient or a caregiver can request palliative care the moment they need more support when receiving treatment to cure an illness. Anyone can ask for palliative care at any point in their journey. There is no time limit or amount of suffering required.
That said, palliative care programs can be tailored to specific illnesses or types of care–such as a clinic focused on Parkinson’s or cancer treatment. Patients and caregivers may need to search for programs that can help them with their specific issues, or if they can work with particular team members in their healthcare setup to get palliative care. Some of these programs may also require a physician’s referral, but on the whole, most do not. When looking at palliative care, here are some things patients and caregivers should consider:
- When a patient wants treatment for a serious illness in tandem with symptom management and pain control
- A focus on comfort and quality of life, including spiritual comfort and focus on goals of treatment
- Experiencing an increase in anxiety and depression during the course of treatment
- A patient and/or caregiver require additional assistance for pain and medication management
Hospice and Palliative Care: Compassionate Support
End of life and severe chronic illnesses are difficult and emotional circumstances for anyone to cope with. Hospice and palliative care are support resources for the patient and you as a caregiver. When families start hospice or palliative care, they experience relief from the burden and stress of caregiving while improving the quality of time they have with the patient.
