Hospice versus Palliative Care: What’s the Difference?

What’s the difference between hospice and palliative care? For patients and families facing serious illness, this is a common question. Ultimately, the goals of both hospice and palliative care are very similar: to relieve symptoms of a serious illness, provide comfort from pain and improve quality of life for the whole family. Yet how these goals are achieved and when a person is eligible for each type of care can be very different. If you missed the March 15 Lunch & Learn, here is more information on this frequently asked question.

Eligibility

Patients in both hospice and palliative care have similar diagnoses. Frequent illnesses include cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, kidney disease, liver disease, dementia, stroke and many others.

Yet where you are in the course of your illness makes all the difference in whether you’re eligible for hospice or palliative care. In order to be eligible for hospice, a doctor must certify that, if the illness runs its natural course, death could be expected in six months or fewer. The individual must also not be receiving curative treatment, such as chemotherapy.

On the other hand, palliative care can be used anytime during the course of a serious illness—starting with the diagnosis—and patients can be receiving curative treatment for their illness. See the “On the Road of Life” image below.

Services Provided

One of the biggest differences between hospice and palliative care is what specific services are provided. The hallmark of hospice care is its interdisciplinary, comprehensive approach. The patient and family has a whole team of professionals assisting them on a regular basis, which can include a nurse, hospice aide, the patient’s primary care doctor, hospice doctor, social worker, chaplain, volunteer and grief counselor.

The “Circle of Care” image below demonstrates this hospice team approach. Patients are seen frequently by different members of the team, sometimes multiple times per week, and sometimes 24-7, as at Beacon Place, HPCG’s inpatient hospice home.

Yet palliative care is less comprehensive and more consultative in nature. After the patient’s health care provider requests a palliative care consultation, one of HPCG’s nurse practitioners meets with the patient to assess the symptoms of their serious illness, whether its pain, nausea, coughing, delirium or anxiety. They then recommend medications or therapies to treat those symptoms. The palliative care team also helps the patient and family better understand the illness, review advance directives and make choices for their future health care decisions.

Where They are Similar

Whether a person is receiving hospice or palliative care, HPCG meets patients wherever they call “home”—in private residences, retirement communities or nursing homes. Moreover, both palliative and hospice care are usually covered by Medicare, Medicaid and private insurance, though the way they are billed can differ.