Palliative and hospice care: Breaking down the differences
If you’re researching care options for a loved one, you might be confused by the terms "palliative care" and "hospice care," as both are associated with comfort and pain management. They both involve a team of professionals such as physicians, nurses, chaplains and social workers, and they both focus on a holistic view of the patient, says Nicole Christensen, director of Care Answered, a Long Island, New York healthcare advocacy group.
Palliative care, however, is much broader in scope, and hospice often takes place at home as opposed to in a hospital setting. Here’s a side-by-side comparison of palliative and hospice care.
The goal of palliative care versus hospice
Palliative care aims to improve your overall quality of life if you’re suffering from a serious illness such as heart failure, chronic obstructive pulmonary disease (COPD), dementia, or even cancer. You’ll still get treatment for the underlying condition, but the palliative team also supports you in various other ways — for example, treating fatigue or weakness that develops as a result of undergoing chemotherapy, or addressing anxiety or depression that you might have as a result of your condition.
Hospice provides comfort care and family support for someone with a terminal illness who usually has six months or less to live. The key difference from palliative care is that you don’t receive curative treatment anymore. But you will get medical care to help relieve symptoms related to your disease, as well as other types of support, such as counseling, help with medical equipment, and grief support.
Who’s eligible for palliative care and hospice
Palliative care is appropriate for anyone with a serious illness (whether it’s chronic, curable or life-threatening).
In contrast, hospice has very specific criteria: It’s for people who usually have six months or less left to live and are no longer pursuing curative care. “The patient may no longer be receiving any benefit from treatment, or may simply decide they don’t want to undergo it anymore,” explains Christensen.
Who provides the care
Palliative care is provided by a team that may include a doctor who specializes in palliative medicine, a nurse, a pharmacist, a social worker, a dietitian, a chaplain, and volunteers.
Hospice care is also provided by a team that may include the hospice medical director, a nurse case manager, a social worker, a bereavement counselor, a home health aide, and hospice volunteers.
Where the treatment is provided
In most cases, people receive palliative care at a hospital, but you can also receive it at an outpatient center, a nursing home, an assisted-living facility, or at home.
Hospice care usually takes place at home or in a nursing home, but there are some residential hospices as well as hospital beds designated for people in hospice.
Insurance coverage for palliative care and hospice
Palliative care is generally covered by private insurance; Medicare Part B and some state Medicaid programs may also offer coverage for some forms of treatment.
Hospice care is covered by Medicare, Medicaid, and most private insurance.
How long care lasts
You can receive palliative care as long it’s helpful, at any stage of your illness, including after you are no longer receiving treatment for your condition. For example, your cancer might be in remission but you may still need help dealing with depression, medical bills, or other side effects from your treatment. If your condition progresses, you may opt to transition over to hospice care, which is, after all, a form of palliative care.
Hospice is meant to provide care and support until the end of life. Although you usually require a prognosis of six months or less in order to qualify for hospice, if you live longer than that, you can continue to receive supportive care.
Written by Hallie Levine, reviewed by Shoshana Ungerleider, MD
Read next: When is it time for hospice?