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

If you or a loved one is facing life after a serious diagnosis like ALS (Lou Gehrig’s disease) or stage 4 cancer, you might have come across information about both palliative care and hospice. 

Both types of care aim to improve comfort and decrease pain when a person suffers from a serious or terminal illness. Both involve a multi-disciplinary treatment team made up of various medical professionals. But, there are important differences between the two types of care. 

In this article, we’ll be looking at the differences between hospice and palliative care. 
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What is Hospice Care? ‍

Hospice care focuses on quality of life and comfort for people with a terminal illness. The focus is on comfort rather than a cure. Choosing hospice doesn't mean you're giving up medical care. Instead, medical treatment is focused on comfort rather than a cure. 

A multidisciplinary team of healthcare professionals provides medical, spiritual, and emotional support. These professionals may include a physician, nurse, aide, social worker, pharmacist, and chaplain. 

Requirements for Hospice 

• A life expectancy of no more than six months: To qualify for hospice, a doctor (MD or DO only) must certify that you have a terminal illness AND less than six months to live. This doesn’t mean that you can’t live more than six months, just that your life expectancy is six months or less. Some people, like Jimmie Carter, remain in hospice for a year or more. 
• Wish to forgo curative treatments: To receive hospice, you must agree to stop treatments aimed at curing your illness. However, that doesn’t mean that you can’t receive medications. Many people in hospice take medications for pain, nausea, anxiety, shortness of breath, and other symptoms. In hospice, medications are used to increase comfort rather than cure a disease. 
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Palliative care 

Palliative care is for people living with a chronic or serious medical illness. It focuses on providing comfort care and symptom control. Like hospice, palliative care includes a team of multidisciplinary professionals such as a doctor, nurse, chaplain, social worker, aide, and more. 

The goal of palliative care is to reduce symptoms and improve the person’s quality of life. 

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Requirements for Palliative Care 

To receive palliative care, you should have a serious potentially terminal illness like: 

• AIDS 
• Alzheimer’s disease
• Cancer 
• Amyotrophic lateral sclerosis (ALS) 
• ​​Rheumatoid arthritis
• Kidney failure
• Parkinson's disease
• Heart failure 
  

Unlike hospice, a person does not have to have a life expectancy of less than six months to receive palliative care. Some people who receive palliative care go on to recover. Also, palliative care can begin at any time after a person is diagnosed. 

If their condition progresses, a person receiving palliative care may become eligible for hospice care. 

How are Palliative Care and Hospice Similar? 

Both palliative and hospice care can improve quality of life and symptom control. They both can help: 

• Increase comfort 
• Provide emotional and medical support 
• Provide caregiver support 
• Coordinate care 

Differences Between Hospice and Palliative Care 

The main difference between these two types of care is that the hospice experience is focused on end-of-life care. Palliative care, on the other hand, is focused on all stages of the illness. 

• Curative or life-prolonging treatment: With hospice, all treatment meant to cure the illness is stopped. Medical treatment meant to cure the condition can continue with palliative care. As an example, a person may continue to receive chemotherapy in palliative care. In hospice, these measures are usually avoided. 
• Continuous vs. intermittent treatment: A person will usually receive hospice care continuously until they die. Palliative care may be continuous, as well. But, it can also be on an as-needed basis. So, a person may only receive it when their symptoms are increased. 
• Treatment team: Hospice usually replaces a patient’s medical team (except for your primary care doctor if you wish). However, with palliative care, a person may continue to receive treatment from their usual medical team (along with the palliative team). 

How To Decide Between Hospice And Palliative Care

Typically, whether or not palliative care vs hospice is right for you depends on the specifics of your medical condition. As noted above, there are generally specific requirements needed to receive either type of care (for insurance to cover it). 

Generally, hospice care may be best if you: 

• Have been told by your doctor that you have less than six months to live
• Have no curative treatments available or wish to no longer pursue curative or life-lengthening treatment
• Want to focus on comfort and pain management 

Palliative care may be the best if you: 

• Have a life expectancy of more than six months
• Have a life-threatening or serious illness
• Want to pursue treatment like chemotherapy that is aimed at curing your illness or prolonging your life 

Recap 

Both hospice and palliative care are options when a person has a terminal illness. However, hospice is only available if you have a life expectancy of less than six months. To determine if you qualify, talk with your primary care physician. 

You can also reach out to us at Transitions Hospice Care. We would be happy to talk to you about your care options and provide more information about hospice.  

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