Palliative Care vs Hospice: What’s the Difference?

It is important for everyone, older adults in particular, to plan ahead and let their family, caregivers, and healthcare providers know their wishes for end-of-life care and the type of care they wish to receive for a severe illness. Two types of care that are provided in the U.S. are hospice and palliative care. Please continue reading to learn the key differences between palliative care vs hospice care.

What is palliative care?

Palliative care is a type of specialized medical care that is provided to people with a serious illness. Palliative care patients continue to receive medical care for their symptoms as well as treatment that can cure their disease. In addition, they receive palliative care services to provide comfort and enhance their quality of life.

Why would a patient be placed in palliative care?

A patient might be placed in palliative care if they are living with a serious disease such as chronic obstructive pulmonary disease (COPD), heart failure, dementia, Parkinson’s disease, cancer, or other chronic illnesses. Palliative care can be started at any stage of the disease but is best begun soon after a person is diagnosed. 

In addition to managing symptoms and improving a person’s quality of life, palliative care focuses on helping patients and their families understand treatment choices. A palliative care organization can provide organized services to patients who need many different services, are in a lot of discomfort, or have significant disability. 

Where are palliative care services provided?

Palliative care can be provided at home or in hospitals, nursing homes, specialized clinics, or outpatient palliative care clinics. 

Who provides palliative care?

Many different healthcare professionals are on a palliative care team, including a palliative care specialist who is usually a physician, nutritionist, social worker, and chaplain. Additional team members may be included based on the needs and level of care required by individual palliative care patients. The team works with the patient’s other healthcare professionals to provide medical care as well as psychosocial and practical support to the patient and their family members. 

Does insurance cover palliative care?

Palliative care may be covered by Medicare, Medicaid, the Department of Veterans Affairs, and private insurance policies. You can use the website of the National Hospice and Palliative Care Organization to find hospice and palliative care clinics near you.

What is hospice care?

Hospice care is a type of specialized medical care that is provided to people with a serious illness who are approaching end of life. Hospice care patients continue to receive treatments for managing symptoms but do not receive treatments that could cure their illness. 

Why would a patient be placed in hospice care?

A patient may be placed in hospice care if it is not possible to cure an illness, the person’s illness is not responding to treatments, or they have chosen not to undergo certain potentially curative treatments. 

Hospice care focuses on symptom relief and improving comfort and quality of life. It is offered when a person has a terminal illness and less than six months to live if the illness runs its usual course. Hospice patients understand that they are forgoing medical treatment that could potentially slow the progress of their disease or cure it. 

It's important for people with serious life-threatening illnesses to discuss the benefits of a hospice program with their doctor. If a doctor believes a person’s condition is incurable, starting hospice early can give several months of comfort and quality time with loved ones to a person who is dying. Delaying hospice until a person is close to death can prevent a patient with severe illness from taking full advantage of all the benefits of hospice care.

Where are hospice care services provided?

Hospice care can be provided at home or in healthcare facilities such as a hospital, nursing home, or specialized hospice center.

Who provides hospice care?

Hospice care is provided by a specialized team of healthcare workers, including doctors, nurses, social workers, chaplains, spiritual advisors for grief support, and trained volunteers to provide emotional and spiritual support. A member of the hospice care team visits the patient regularly and is available to provide phone support 24/7. Hospice patients who are at home receive day-to-day care from a family member or friend.

Does insurance cover hospice care?

Hospice may be covered by Medicare and private insurance plans.

What is the difference between palliative care and hospice?

Here are the key differences between palliative care vs hospice:

Who can be treated?

Palliative care is for anyone with a serious illness. Hospice care is for anyone with a serious life-limiting illness who has a short time (usually less than 6 months) to live.

Where is care provided?

Both palliative care and hospice can be provided at home, in a doctor’s office, outpatient clinics, assisted living facilities, nursing homes, and hospitals. In addition, palliative care may be offered at specialized palliative care clinics and hospice care at a specialized hospice facility.

How are palliative and hospice services provided at home?

The palliative care team treats symptoms at home instead of in a healthcare setting and provides care based on a patient’s needs. The hospice team provides day-to-day support while the person dying at home is cared for by family and friends. Support from the hospice team includes coaching family members on how to care for the patient and providing respite care when caregivers need a break.

What type of treatment is provided?

Both hospice and palliative care provide meaningful care for symptom management. However, the main difference between palliative care and hospice is that while palliative care patients can continue to receive treatments to cure their illness, hospice patients do not receive curative treatments. 

Are palliative and hospice services covered by insurance?

Coverage for palliative medicine and hospice care depends on your health insurance plan and benefits. Palliative and hospice care may be a Medicare benefit.

How long can you receive palliative and hospice services?

You can receive palliative care for symptom management of pain and other symptoms as well as curative care as long as you need it, depending on whether your insurance will cover palliative care. Most people receive hospice care for as long as they meet the criteria of an illness with a life expectancy of months rather than years (usually six months or less). If a person’s condition improves or goes into remission, it may be possible to leave hospice care.

Is palliative care the last step before hospice?

Palliative care is not necessarily the last step before hospice. Both palliative care and hospice care provide comfort and improve a person’s quality of life. However, palliative care can begin at the time of diagnosis and continue alongside curative care. If the palliative care team believes treatment is no longer helping and the patient is likely to die within six months, they may transition the patient to hospice. Or they may continue providing palliative care with a greater emphasis on comfort and quality of life. Hospice care begins after curative treatment for the disease is stopped, and it is clear that the person cannot survive the illness.

Is palliative care only for end-of-life?

No, palliative care is not only for end-of-life care. Having palliative care does not mean a person is going to die soon. Palliative care can start at the time a condition is diagnosed. It is much broader than end-of-life hospice care and can last longer, even years.

Is hospice for serious illness?

Hospice care is for people in the final stages of a serious illness who are approaching the end of life. It focuses on easing pain, providing comfort, and improving quality of life while forgoing treatment options that could potentially cure the condition. People who have a serious illness but are not approaching the end of life may benefit from palliative care.