Hospice Care and Palliative Care
A common question asked in the community is the difference between Hospice Care and Palliative Care. In this era, we seldom are educated in the medical setting and are sent home with more questions than answered.
Internet research can lead to misunderstanding, misinformation, and grief-led rabbit holes. This adds stress and trauma to a situation that is experiencing change and loss.
With the rush & acute-care focus in U.S, Western Healthcare, facilities and healthcare professionals lack the time to explain and educate families, let alone help guide them, on the processes of Hospice Care or Palliative Care. Often families have no idea what to expect or what to ask for to advocate for their person’s comfort.
Both, Hospice Care and Palliative Care, focus on providing comfort and support to patients with serious illnesses, but they have distinct differences in terms of their goals, timing, and scope of services. Here's a comparison to clarify these differences:
Hospice Care:
Purpose:
Hospice care is designed for patients who are in the final stages of a terminal illness, typically with a prognosis of six months or less to live.
The primary goal is to provide comfort and improve the quality of life in terms of comfort and emotional support, rather than to cure the illness.
Eligibility:
Patients must be certified by a physician as terminally ill with a life expectancy of six months or less if the disease follows its natural course.
Patients must agree to forgo curative treatments in favor of palliative measures.
Location:
Hospice care can be provided in the patient's home, hospice centers, hospitals, or nursing facilities. Patients in this stage of end of life opt for the comforts of home.
Services:
Most hospice services including pain and symptom management as well as navigating insurance documents. Assistance with daily living activities are usually provided by the family.
While emotional, spiritual, and bereavement support are sometimes provided by affiliated religious organizations, and / or by a death doula who also offer additional services like systemic navigational support for individuals and families.Hospice care is an Interdisciplinary team approach including family, death doulas, doctors, nurses, and chaplains (if religious affiliation).
Insurance Coverage:
Typically covered by Medicare, Medicaid, and most private insurance plans, with a focus on palliative rather than curative treatments.
Palliative Care:
Purpose:
Palliative care is for patients at any stage of a serious illness, whether it is terminal or chronic.
The goal is to relieve symptoms, pain, and stress of the illness, improving quality of life for both the patient and their family.
Eligibility:
Patients with serious, life-limiting illnesses at any stage, including those undergoing curative or life-prolonging treatments.
No requirement for a specific prognosis or life expectancy.
Location:
Palliative care can be provided in various settings such as hospitals, outpatient clinics, long-term care facilities, and at home.
Services:
Symptom management (pain, nausea, fatigue, etc.), emotional and psychological support, coordination of care, and support for decision-making about treatment options.
Typically involves a team of specialists including doctors, nurses, social workers, and other healthcare professionals.
Insurance Coverage:
Often covered by Medicare, Medicaid, and private insurance, especially when provided as part of hospital-based care. Coverage for outpatient palliative care varies.
Key Differences
Timing and Disease Stage:
Hospice Care: Reserved for the final months of life, with a focus on end-of-life care.
Palliative Care: Available at any stage of a serious illness, from diagnosis onward, alongside curative treatments.
Treatment Focus:
Hospice Care: Focuses solely on palliative measures and comfort care, without curative intent.
Palliative Care: Can be provided alongside curative or life-prolonging treatments.
Eligibility and Goals:
Hospice Care: Requires a terminal diagnosis with a specific life expectancy and a decision to forgo curative treatments with a DNR (do not resuscitate) order in place.
Palliative Care: No requirement for a specific prognosis or decision to forgo curative treatments; focuses on improving quality of life and managing symptoms at any illness stage.
