Palliative Care vs. Hospice Care: What is Right for You?

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When facing end-of-life issues, understanding the benefits of palliative care vs. hospice care can provide a great deal of peace to those in difficult times.

Also known as “end of life” care or “comfort” care, these treatments both seek to provide excellent quality of life to the seriously ill. However, there are several differences between the two courses of treatment.

Anyone with a life-threatening illness can seek palliative care, vs. hospice care, which is usually only available to the terminally-ill. Hospice care prioritizes caring for the patient, while palliative care seeks to cure the patient.

Palliative Care

Palliative care helps anyone suffering from a serious illness feel better. The goal is to prevent or treat both the symptoms and the side effects of a disease.

These diseases may include:

• Cancer
• Heart disease
• Lung diseases
• Kidney failure
• Dementia
• HIV/AIDS
• ALS (amyotrophic lateral sclerosis)

These diseases impact patients in a number of ways. Besides the physical symptoms and side effects, a disease can threaten a patient’s emotional well-being.

Serious illness takes a toll on the mind and the soul. When we face the possibility of death, we face fears and questions and doubt. We reflect on our past triumphs and mistakes. We worry about missed opportunities and potentially unreachable futures.

Palliative care does not just treat physical symptoms. Palliative care also focuses on the psychological and emotional components of illness. This method of caretaking attempts to soothe social, practical, and spiritual problems. These types of issues can often be prompted by serious illness.

When implemented effectively, palliative care prevents and treats suffering. It optimizes a patient’s quality of life through a focus on comprehensive symptom management and pain control.

Palliative care also seeks to cure the patient of the disease, if and when possible. Curative treatments are sought and administered.

Several studies have shown that patients in palliative care programs have better experiences with their medical care. Palliative care treatment controls their symptoms. They are also able to communicate their emotional needs with specialists trained to meet those needs.

Treatments may include:

• Medicine
• Nutrition and dietary regulation
• Physical therapy
• Occupational therapy
• Counseling
• Support groups

Palliative care specialists often work in teams to coordinate the best care. According to the National Palliative Care Registry, the average size of palliative care teams has increased by 50% since 2009.

One study on cancer treatments and palliative care showed that patients who entered earlier fared better. The study compared one group of patients to patients who entered treatment three months later. After one year of enrollment, the survival of the first group was improved.

Hospice Care

Hospice care programs provide care for terminally ill patients. The goal is to alleviate suffering for those facing the end of life. Hospice care focuses on caring for the patient rather than curing the illness.

Hospice care treats the person rather than the disease. According to one study, 94% of hospices reported annually tracking patient satisfaction.

The emotional and psychological well-being of the patient matters more than extending life.

In this way, hospice care prioritizes the quality of the patient’s life rather than its length. Death is accepted as the final stage of the illness. Hospice care recipients are not trying to avoid it but to prepare for it.

The National Hospice and Palliative Care Organization estimates that approximately 1.2 million deaths occurred under hospice care in the United States in 2014.

Most hospice care is provided in the patients’ homes. Patients are most able to feel comfortable in a familiar environment. And in end of life care, comfort is the chief goal.

About 60% of hospice patients receive care in their homes. The remaining 40% receive hospice care in nursing homes, hospitals, or more often, in individual hospice centers.

As with palliative care, hospice care treatment is largely administered by teams. Hospice care providers may include:

• Nurses
• Physicians
• Social workers
• Chaplains
• Dieticians
• Trained volunteers

These experienced specialists know the best ways to ease the suffering of a terminally ill patient. Hospice care treatments may include:

• Pain and symptom control
• Home care and inpatient care
• Spiritual care
• Family meetings
• Coordination of care
• Respite care
• Bereavement care

The treatment is holistic. Loved ones and spiritual advisors are part of the treatment team. Care providers seek to meet all possible needs of the terminally ill patient.

According to the Centers for Disease Control and Prevention, there were 4,000 hospice care agencies in the United States in 2014. Approximately 1.3 million patients took advantage of hospice care in 2013.

Differences Between Hospice and Palliative Care

Hospice care and palliative care treatment procedures are very similar. They both focus on taking excellent care of seriously ill patients. However, there are many differences to consider when seeking either line of treatment.

When comparing hospice vs. palliative care, it’s important to know that hospice programs outnumber palliative programs.

Time Span

Both hospice and palliative care comfort the ill. But palliative care is offered earlier in the disease process. It can begin at diagnosis and be administered at the same time as treatment.

Any patient with a serious illness can receive palliative care, vs. hospice care, which is usually reserved for terminally ill patients facing six months or less to live. Hospice care is offered when other treatments are no longer controlling the disease.

Hospice care is often not started soon enough. Patients feel that entering hospice care amounts to giving up. However, patients who enter hospice care can leave or opt out at any time. And hospice recipients live longer on average than patients receiving standard care!

Due to the stigma, many patients who might benefit from hospice care delay seeking treatment. Approximately one-third of hospice users enroll for less than a week.

The median time spent in hospice care is 18 days. That means about half of hospice patients received care for fewer than 18 days, and half of the patients received care for more than 18 days.

Medicine and Insurance

Life-prolonging medications are used in palliative care vs. hospice care, which does not use life-prolonging medication. The treatment is refocused on managing symptoms rather than curing the illness.

Insurance coverage for hospice care can vary. It is likely that palliative care is covered by your regular medical insurance.

Common Ground

Both palliative care and hospice care involve the patient’s family. Care providers seek to ease the psychological and emotional suffering of family members. Specialists assist them in supporting their loved one through the illness.

Both palliative care and hospice care seek to relieve symptoms as much as possible.

Finally, hospices are actually the largest providers of palliative care services. Most organizations offer a seamless path of care over the course of these serious illnesses.

The following video talks more about the differences:

Making the Choice

Facing a serious illness is difficult. We have an enormous amount of information available about treatment options, and that can be overwhelming.

But if you or a loved one is determining whether to seek palliative vs. hospice care, it’s important to know the capabilities and benefits of each option. It’s important to educate yourself on the treatments available.

Day to Day

Patients in hospice care can focus on getting the most out of the time remaining, without the negative side effects of some medications.

Especially in the case of cancer, treatment of the disease often makes a patient feel worse on a daily basis. Your doctor may not expect you/your loved one to live longer than six months. If that is the case, it may provide a better quality of life to forgo curative treatment.

However, there are no time limits for when you can receive palliative care, vs. hospice care typically being available only to those with six months or less to live. Palliative care, then, serves to fill a gap for patients seeking comfort at any stage of their disease.

Do Your Research

Note that some hospice and palliative care treatment programs may differ from the general standards.

For example, some hospice programs provide life-prolonging treatments. Some palliative care programs focus on end-of-life care.

As hospice care is available to terminally ill Medicaid participants, each state determines the life

expectancy required to receive hospice care under Medicaid. Some states offer hospice care with up to 12 months left to live. Investigate any relevant guidelines in your state.

Investigate any specific line of treatment, and talk with your doctor to help you make your decision. Talk with your family and anyone potentially involved in administering the end of life care.

Conclusion

Learn the benefits of palliative care vs. hospice care to better prepare for receiving either treatment. Palliative care seeks to prevent or treat symptoms, while hospices aim to improve the quality of life for the terminally ill.

If you have any questions about the benefits of palliative care or hospice care, feel free to ask in the comments.