Palliative Care vs. Hospice: Understanding the Differences and Choosing the Right Support

Author: Precious Kilpatrick RN, MSN

In the United States 129 million people have at least one chronic illness. Seven thousand people die daily from various diseases. Worldwide, twenty million people have a need for end-of-life care. Many people are unaware of the support resources that are available to assist during these crucial times. During a serious illness, having supportive care makes a world of difference. At the end of life, supportive care is just as important. Both palliative care and hospice care are two medical-based supportive services that are available during the time of a serious illness. There are both similar goals and distinct differences between the two.

What is Palliative Care

Palliative care may be provided alongside curative treatment. It focuses on the whole person–spiritual, physical, and mental. Chronic diseases come with burdensome symptoms such constipation, diarrhea, shortness of breath, pain, anxiety, depression and poor appetite. Palliative care provides symptom management, emotional support, and support for family and care givers.

A common misconception of palliative care is it only applies to the end stage of life. However, palliative care can be delivered at any stage of a serious illness. 

What are serious illnesses? Common serious illnesses that people seek palliative treatment for include chronic obstructive pulmonary disease (COPD), heart failure, cancer, multiple sclerosis, AIDS, and stroke. These are only a few however, there are other conditions that would benefit from palliative care.

What is Hospice

Hospice is a medical-based service provided for the end-of-life when life expectancy is 6 months or less. Hospice care focuses on providing comfort and bringing dignity to the dying process in the last days of life. Hospice staff provide spiritual, mental, and psychosocial support for patients and their family. 

Families are able to focus on making memories and ensuring essential affairs and arrangements are made. Curative measures such as chemotherapy and radiation are no longer pursued. However, acute issues such as infections are addressed by the hospice providers. 

There are two prominent misconceptions of hospice care. 

•  The person on hospice care will lay in bed and suffer from pain until they pass away.

• The patient will be given pain medication that will speed up the dying process.

A major component of hospice is managing pain. Patients and family receive reassurance from knowing that although death may be imminent, it will not be painful. Additionally, hospice doesn’t hasten the dying process, rather it provides comfort, support, and dignity during the dying process to allow death to occur naturally.

Shared Goals

The goal of both palliative care and hospice care is improving the quality of life. Quality of life refers to an individual’s overall well being and satisfaction with their physical, mental, social and personal life. Symptom management and providing various levels of support are the mainstay of both of these services.

 It is the goal of both palliative and hospice care to provide symptom management. 

Chronic and end stage diseases unfortunately are accompanied by a burden of symptoms. These symptoms may include nausea, fatigue, loss of appetite, weight loss and pain. Alleviating burdensome symptoms helps with the toleration of a disease.

 Emotional, spiritual, and psychosocial support are also similar components of palliative and hospice care. These supports aren’t for the patients alone, but family as well. More often than not, families need resources to help with the adjustment to life that an illness has introduced. These can be caregiver resources, respite care, care facility information, counseling, support groups, and chaplain support. 

Key Differences

Palliative and hospice care have key differences. The differences are the time of initiation of services and treatment goals. Palliative care can begin at any stage of diagnosis whether new or in the chronic stages. Hospice care starts at the end of life, typically with a life expectancy of 6 months or less. Palliative care is inclusive of curative treatment options such as chemotherapy, treatment by specialists, and visits to the hospital with acute life-threatening episodes. Hospice care focuses on comfort solely and not seeking curative treatments. Alleviating symptoms is part of providing comfort.

Setting

Palliative care can occur in a home, clinic setting or a care facility. Likewise hospice care can occur in a home or care facility setting or a hospital if the hospital provides the service.

Insurance

Most private insurances provide some coverage for palliative and hospice care as well as Medicare, Medicaid, and veteran benefits. Insurance companies are able to inform beneficiaries of what is covered.

Conclusion

Palliative and hospice care are both services utilized in serious illness. Although there are some key differences, providing symptom management along with emotional, spiritual, mental, and psychosocial support contributes to the improvement of quality of life.

Sources

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Assessed and Endorsed by the MedReport Medical Review Board