The Differences Between Hospice Care and Palliative Care

May 5, 2016

The Differences Between Hospice Care and Palliative Care

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Hospice and palliative care are very similar in that they are part of the end-of-life care conversation. The objective of both programs is to provide pain and symptom relief for sick patients, however, the end-goal of these programs tend to differ.

What is hospice care?

Hospice care is a specific type of end-of-life care that provides support and care for a dying person. Generally, the individual has less than 6 months left to live. The goal of this type of care is to help a dying individual have peace, comfort, and dignity during their last days. Though commonly provided in the home, hospice care is also available in a hospice center, a hospital or other skilled long-term care facility.

A hospice team will consist of healthcare professionals and trained volunteers who will provide medical, psychological, and spiritual support for a dying person. This includes providing support services for the patient’s family as well. Their goal is to control pain and other symptoms so the individual can remain as alert and comfortable as possible.

What is palliative care?

Palliative care is specialized medical care for the purpose of improving the quality of life for seriously ill patients that may or may not be terminally ill. Also referred to comfort care, palliative care focuses on pain management and symptom control.

Palliative care does not need to necessarily be for serious illness. For example, when you break a bone, you will get a cast, the doctor may also prescribe you painkillers to make you more comfortable. The act of the doctor prescribing you those painkillers is palliative care.

Differences between hospice and palliative care

One difference between hospice and palliative care is that to qualify for hospice care, a physician must declare you terminally ill, and you must have a prognosis of 6 months or less if the disease runs its normal course. With palliative care, it doesn’t matter whether a patient has a terminally ill condition or not, and there is no time restriction for prognosis.

Though hospice care is available in hospitals, extended care facilities, and nursing homes, hospice care is primarily provided in the home. Palliative care is generally provided in a hospital, extended care facility or nursing home.

The intent of these programs also differs. With hospice care, the purpose is to care, not cure. Caring services are provided, but without regard to life-prolonging treatments. Hospice care concentrates on helping the patient remain as alert and comfortable as possible during their end-of-life. Hospice patients are generally no longer receiving curative treatments. Palliative care is for comfort care for any stage of the disease, and treatments to extend life will not be evaded.

If your loved one is eligible for Medicare, then his or her hospice care may be covered. There are specific requirements that they will need to meet to be eligible for hospice care coverage such as having your regular doctor and a hospice medical director certify that you’re terminally ill with a life expectancy of 6 months or less and that you are willing to accept palliative care for comfort, instead of to cure your illness. Palliative care is generally provided through your hospital or regular medical provider, so it is very likely that your medical insurance will cover it. While hospice care covered by Medicare is billed more like a packaged service, palliative care will be billed individually, just like separate doctor and hospital visits.

The main distinction between hospice and palliative care is that hospice is always palliative care, but palliative care is not always hospice.

Rejecting life-prolonging treatment

One of the requirements to receive Medicare-covered hospice care is that you must accept palliative care for comfort instead of care to cure your ailment. One may wonder what are circumstances in which you would choose to receive palliative care, but not curative treatment.

One of the main reasons is that the patient no longer has curative options or that they may choose to not to pursue these options because the side effects outweigh the benefits. Other reasons may include:

  • The patient has limited ability to care for him or herself.
  • The patient has received curative treatment but is no longer benefitting from it.
  • The patient does not qualify for an appropriate clinical trial.
  • There is no evidence that further treatment would be effective.

If your loved one is terminally ill, any combination of the characteristics listed above could be a reason why they may choose to receive palliative care without the intent of prolonging life.

If you or a loved one is terminally ill, speak with your family and doctor about goals and whether palliative care or hospice care is best for preserving the quality of life.

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Frequently Asked Questions

Am I still eligible for hospice if I'm already in a nursing home or long-term care facility?

One of the major benefits of hospice care is that you are able to receive it whether you are at home, a hospital, a long-term care facility or nursing home. You can choose where you would like to receive your hospice care.

See All Answers »

Are there any signs that the end may be near for hospice patients?

There are some common signs that death is near and they include:

  • Shortness of breath (dyspnea)
  • Depression
  • Anxiety
  • Tiredness/Sleepiness
  • Mental confusion
  • Constipation or incontinence
  • Nausea
  • Refusal to eat or drink
  • Parts of the body becoming cool to the touch or darker or blue in color

It is important to remember that these signs alone do not mean that someone is dying. However, for seniors that are in hospice or declining health and experience many of these symptoms, it could suggest that they are nearing the end of their life.

See All Answers »

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