Palliative care and hospice care both focus on the comfort, care, and quality of life of individuals with a serious illness. Hospice care is a specific type of palliative care that is provided in the final weeks or months of life. Although these two forms of care are similar in some ways, they can differ as to when and where care is received, and which treatment options are available. Learn more about these two types of care to help determine which may be most appropriate for you or a loved one.
What is palliative care?
Palliative care is focused on improving quality of life for people with serious illnesses and their care partners. It is available to people of any age who need it, not just older adults. The major elements of palliative care include managing a person’s symptoms effectively and ensuring that their care is coordinated.
Palliative care is interdisciplinary, which means that it involves multiple types of doctors and other care providers. These providers work together with patients and their families and care partners to ensure that the treatment plan reflects the person’s goals and values.
Palliative care can start as early as a person’s diagnosis or not until later in their illness, and it can occur alongside other types of treatment for the disease. This form of care includes, but is not limited to, advance care planning, end-of-life care, hospice care, and bereavement support.
Who can benefit from palliative care?
Palliative care is a resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease, cancer, dementia, Parkinson’s disease, and many others.
In addition to improving quality of life and helping with symptoms, palliative care can help patients understand their choices for medical treatment. The organized services available through palliative care may be helpful to any older person having a lot of general discomfort and disability very late in life.
Who makes up the palliative care team?
A palliative care team is made up of multiple different professionals who work with the patient, family, and the patient’s other doctors to provide medical, social, emotional, and practical support. The team is composed of palliative care specialist doctors and nurses, and includes others such as social workers, nutritionists, and chaplains. A person’s team may vary based on their needs and level of care. To begin palliative care, a person’s health care provider may refer them to a palliative care specialist. If a referral isn’t suggested, the person can ask their health care provider for one.
Where is palliative care provided?
Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home. Medicare, Medicaid, and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance might pay for some services. Health insurance providers can answer questions about what they will cover.
Visit the National Hospice and Palliative Care Organization website to find palliative care near you.
In palliative care, a person does not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment and may begin at the time of diagnosis. Over time, if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities. Palliative care could transition to hospice care if the doctor believes the person is likely to die within six months (see What does the hospice six-month requirement mean?). Or, the palliative care team could continue to help with increasing emphasis on comfort care.
For a closer look at how this transition can work, the National Institute on Aging’s video “Understanding End of Life Care Options” walks through what to expect. For more information, check out NIA’s article on Frequently Asked Questions About Palliative Care.
What is hospice care?
Increasingly, people are choosing hospice care at the end of life. Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life.
At some point, it may not be possible to cure a serious illness, or a patient may choose not to undergo certain treatments. Hospice is designed for this situation. A patient beginning hospice care understands that their illness is not responding to medical attempts to cure it or to slow the disease’s progress.
Like palliative care, hospice provides comprehensive comfort care as well as support for the family, but in hospice, attempts to cure the person’s illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes they have six months or less to live if the illness runs its natural course.
It’s important for a patient to discuss hospice care options with their doctor. Sometimes people don’t begin hospice care soon enough to take full advantage of the help it offers — perhaps they wait too long and are too close to death, or they aren’t eligible soon enough to receive its full benefit. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones.
Where is hospice care provided, and who provides it?
Hospice is an approach to care, so it is not tied to a specific place. It can be offered in two types of settings — at home or in a facility such as a nursing home, hospital, or a separate hospice center.
Read more about where end-of-life care can be provided.
Hospice care brings together a team of people with special skills — among them nurses, doctors, social workers, spiritual advisors, and trained volunteers. Everyone works together with the person who is dying, the caregiver, and the family to provide the medical, emotional, and spiritual support needed.
A member of the hospice team visits regularly, and someone is usually always available by phone, 24 hours a day, seven days a week. Hospice may be covered by Medicare and other insurance companies. Check to see if insurance will cover your particular situation.
It is important to remember that stopping treatment aimed at curing an illness does not mean discontinuing all treatment. A good example is an older person with cancer. If the doctor determines that the cancer is not responding to chemotherapy and the patient chooses to enter hospice care, the chemotherapy will stop — but other medical care may continue as long as it is helpful. For example, if the person has high blood pressure, they will still get medicine for that.
| Question | Palliative Care | Hospice |
|---|---|---|
| Who can be treated? | Anyone with a serious illness | Anyone with a serious illness who doctors think has only a short time to live, often less than six months |
| Will my symptoms be relieved? | Yes, as much as possible | Yes, as much as possible |
| Can I continue to receive treatments to cure my illness? | Yes, if you wish | No, only symptom relief will be provided |
| Will Medicare pay? | It depends on your benefits and treatment plan | Yes, it pays for some hospice charges |
| Does private insurance pay? | It depends on the plan | It depends on the plan |
| How long will I be cared for? | This depends on what care you need and your insurance plan | As long as you meet the hospice’s criteria of an illness with a life expectancy of months, not years |
| Where will I receive this care? |
|
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Source: Palliative Care or Hospice? (PDF, 74K). Copyright © National Hospice and Palliative Care Organization. All rights reserved.
Although hospice provides a lot of support, the day-to-day care of a person dying at home is provided by family and friends. The hospice team coaches family members on how to care for the dying person and even provides respite care when caregivers need a break. Respite care can be for as short as a few hours or for as long as several weeks.
What are the benefits of hospice care?
Families of people who received care through a hospice program are more satisfied with end-of-life care than those who did not have hospice services. Also, hospice recipients are more likely to have their pain controlled and less likely to undergo tests or be given medicines they don’t need, compared with people who don’t use hospice care.
If you or a loved one are weighing palliative care or hospice care, the team at Hospice of Lenawee is available to talk through your options. Contact us to learn more.
You may also be interested in
- Exploring frequently asked questions about hospice care
- Learning about different care settings at the end of life
- Reading about making care decisions at the end of life
For more information about hospice and palliative care
- NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
800-438-4380
[email protected]
www.nia.nih.gov/alzheimers - Alzheimers.gov
www.alzheimers.gov - CaringInfo (National Hospice and Palliative Care Organization)
800-658-8898
[email protected]
www.caringinfo.org - Center to Advance Palliative Care
212-201-2670
[email protected]
www.getpalliativecare.org - Hospice Foundation of America
800-854-3402
[email protected]
www.hospicefoundation.org - Education in Palliative and End-of-Life Care
312-503-3732
[email protected]
www.epec.net
This article is based on general health information from the National Institute on Aging (National Institutes of Health), content reviewed May 14, 2021. Read the original resource: “What Are Palliative Care and Hospice Care?”, National Institute on Aging.