Palliative Care Vs Hospice Care: What’s the Difference?

With long-term illness, palliative and hospice care can address complementary issues- but which one do you need and how will you pay for it?

When you or a loved one face a debilitating illness, such as cancer, stroke, or traumatic injury, it can be disheartening. There’s likely to be more involved in your medical care than medical treatment of your condition. You’ll often need long-term care, whether in a hospital, a rehabilitation facility, or at home.

Treatment for your condition or illness may include surgery, radiation or chemotherapy, or physical therapy. Other treatments may be palliative—pain management or emotional/psychological support.

Or, in the case of end-stage disease, you may simply want to be comfortable and comforted. Hospice care offers end-of-life care and includes palliative care.

What are the characteristics of palliative care?

Palliative care is specialized medical care that relieves the stress and symptoms of illness. For example, chronic pain can lead to depression. The goal is to improve and support a better quality of life for you as a patient and your family.

Doctors, nurses, and many specialists are trained to offer holistic supportive care. They work to provide supportive care alongside your primary medical team.

Because it’s based on patient needs and goals, palliative care isn’t dependent on your diagnosis. Anyone suffering a serious illness, regardless of prognosis, can benefit from palliative care.

The emphasis of such supportive care is on relief, whether from pain or other severe symptoms. The care isn’t limited to physical symptoms, either. Palliative care also addresses any emotional or spiritual needs you might have.

Your family will benefit from knowing that you are getting the best possible care on all fronts. It can also help support you as you face medical treatment choices.

In a German survey of patients who were receiving palliative care, researchers found a thematic constant in patients’ needs: “having a choice and being in control,” “being connected to family,” and “physical comfort.”

What is hospice care?

Hospice care is specialized end-of-life care; it focuses on patients’ and their families’ quality of life. The goal is to give you the best quality of life possible as you face incurable disease.

Usually, hospice care includes palliative support, as well as whatever medical treatment you might choose. Hospice’s goal is to give you as much control over your care and disease progression as possible.

In general, hospice care begins about the last six months of life. It’s designed to help you be comfortable and to accept the impending end of life.

Most hospice care is home-based but could also be offered at inpatient hospice, extended care, or hospital facilities.

Your hospice team helps you manage supportive care for you and your family. That includes many of the aspects of palliative support—whether mental, emotional, physical, and social—for your caregivers and family.

Although most hospice care takes place at home, there might be times when you need to be in a hospital, extended-care facility, or an inpatient hospice center. In fact, while you may enter into hospice care in a facility, you can later decide to change to in-home hospice. And, the reverse is also true.

Four levels of hospice care

All Medicare-certified hospice providers have to provide four levels of care:

• In-home hospice care at home, if you choose to take advantage of it.
• Continuous care, simply this is around-the-clock care as required.
• Inpatient hospice care if required to manage around-the-clock care.
• Respite care to allow family or other caregivers a break from providing care.

When should I begin hospice or palliative care?

You may feel that entering hospice is “giving up.” But hospice care is about preparing you to decide about your care and supporting you as you receive treatment.

When should you consider palliative care?

If you or a loved one are experiencing difficult symptoms because of severe illness, injury, or because of treatment, talk with your doctor about palliative care. Even though you don’t need or want hospice care, you can and should ask about supportive palliative care to address your symptoms.

How do you know it’s time for hospice?

Some signs that you might want to consider hospice include:

• Frequent hospitalizations, emergency room visits
• Reoccurring or frequent infection
• A decreased appetite that results in severe weight loss
• Rapidly declining health during the last six months despite aggressive medical treatment
• Unrelieved pain, nausea, or shortness of breath
• Increased withdrawal, sleepiness, or mental confusion, or decreased alertness
• Difficulty performing tasks of daily living
• You choose to focus on your quality of life instead of treatment

The American Cancer Society cites studies showing that hospice care is often delayed. That could be because either you, your family, or your doctor may feel it’s too soon.

Understandably, you may be unwilling to go into hospice care. However, hospice is meant to empower your life, not give up hope. Don’t forget you can be in hospice and then decide to move to active treatment.

Palliative care is an integral part of hospice services. Hospice is meant to make you or your loved one comfortable in the final stages of your illness. Likewise, palliative care in tandem with medical treatment is an option.

How to pay for palliative or hospice care.

Your insurance plan is likely to cover palliative care expenses, in full or in part. Also, Medicare or Medicaid will pay for palliative care. You can discuss your financial circumstances with your palliative care team’s social worker or insurance provider.

Everyone is eligible for hospice care, whether or not you can pay. Medicare, Medicaid, and many health plans also cover hospice care. Your doctor and the hospice’s medical director must certify you are “terminally ill.”

Palliative care provides supportive care for severe symptoms during your recovery from a prolonged illness or traumatic injury. It’s also part of a patient-centered, holistic approach to hospice care.

In addition to pain management, palliative care—and hospice—offer emotional, mental, and social supportive care. Your palliative care team empowers you to make clear decisions about your treatment options.

If you are considering either program of care, talk with your doctor about your options.