What is the Difference Between Palliative and Hospice Care?

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For those experiencing serious illness, comfort care may be the best course of action. There are two common avenues that patients and their caregivers may follow to pursue comfort: palliative care and hospice care. While they both share common goals in offering relief to patients, they are radically different in their intended purposes. Understanding the difference between the two can be helpful when making care-related decisions.

What is Palliative Care?

Palliative care is a form of comfort care often provided to a patient concurrently with curative treatment. This type of care may begin at any stage of illness at the discretion of a physician, regardless of whether or not the patient is terminally ill, and in many cases is recommended at the time of diagnosis. Palliative care aims to preserve a patient’s quality of life by managing and helping to relieve their symptoms.

Palliative care is most frequently provided in hospitals, outpatient facilities, and care homes but can be provided at a patient’s home as well. Over time, if a patient receiving palliative care stops responding to treatment or no longer wants treatment, and is estimated to have fewer than six months to live, doctors may recommend transitioning them to hospice care, emphasizing comfort care.

What is Hospice Care?

Hospice care is another form of compassionate comfort care that focuses on managing symptoms and side effects, delivering a better quality of life for patients with a prognosis of fewer than six months to live. The recommendation for hospice care is made when a patient refuses or stops responding to curative treatments. More often than not, hospice care is provided in the patient’s home but can be provided at a hospice facility or a hospital as well. The goal for patients in hospice care is for each day to be as comfortable as possible so that they may live out their final days with dignity, without pain, and have the highest quality of life possible at the end of life.

Where Do They Overlap?

While palliative care and hospice care serve two very different functions, they share several common goals for patients. Both are considered forms of compassionate comfort care and aim to reduce stress and discomfort for the patient with severe (or terminal) illness symptoms. Comfort care is intended to provide not just physical relief but also psychosocial relief, aiding patients as they navigate challenging conversations and decision-making throughout their illness and care journey.

Making Care Decisions

While it is never easy to begin making decisions relating to comfort care, it is recommended that patients start giving thought to their advanced care needs from the time they are diagnosed. Having these conversations with family, friends, and doctors early often leads to a comfortable outcome that most closely aligns with a patient’s wants, needs, and best interests.

 

When Hospice Care is the Final Care Before a Death

After someone dies under hospice care in their own home, the procedures may vary slightly by location. Depending upon the situation, the hospice team – composed of usually a nurse and a volunteer who provides respite to the family as needed – assigned to the patient provides the needed medical supplies (oxygen, latex gloves, adult diapers, a hospital bed, etc.) as well as medication. The hospice team considers the patient’s comfort and pain management the primary focus of providing care.

When the patient dies, the family notifies the hospice team and the team helps the survivor with next steps. Typically, the body is removed when it is best for the survivors. The larger medical equipment, like a hospital bed, is picked up as soon as possible after the body has been removed.

It’s important to note that hospice care is typically covered by Medicare (as is palliative).

Summary

Overall, the common goal shared by both palliative and hospice care is to ensure that the patient experiences as much symptom relief as possible, minimizing pain and discomfort. While palliative care can help patients at any stage of their illness, hospice is meant to serve patients at the end of their lives. Palliative care can be provided alongside curative treatments, and hospice care focuses on providing comfort at the end of life. For seriously ill patients, compassionate comfort care has the intention of easing suffering, making their last days less difficult.

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