Palliative Care vs Hospice Care: When To Consider Each Option
Hospice is a type of end-of-life care for patients with a terminal illness. Palliative care is medical care for patients at any stage of a serious illness. Both are types of comfort care, focusing on managing symptoms and improving patient quality of life. Both can be in-home care or delivered in a nursing home or other facility.
Because they are commonly confused, it can be difficult for families to know when a loved one needs a hospice team or a palliative care team. Here, we talk about how the two services are different. We’ll also explain when it’s time to consider palliative care and when your loved one is ready for hospice care services.
Check out the Trualta library for more resources on hospice, palliative care, and other topics related to caregiving. Use this link to find out if you have free access.
How Are Hospice & Palliative Care Different?
Hospice care and palliative care are distinct and often misunderstood types of healthcare. They are both for patients with serious illnesses. They both focus on symptoms and quality of life rather than curative care. Both types of care can be delivered as home hospice care or in a medical setting, including a nursing home or hospice facility.
There are a couple of key differences between palliative and hospice care:
Life Expectancy
A major difference between palliative care and hospice care is the patient’s life expectancy. A physician does not recommend hospice until they expect a patient to have six months or less to live. Hospice is considered end-of-life care. On the other hand, a patient with a serious illness can receive palliative care services at any stage.
Curative Care
Another difference is whether or not a patient continues receiving curative treatments. Hospice patients stop treatment for their illness because the treatments are no longer beneficial and cause more burden than benefit.
Palliative care is not a replacement for primary treatment of the disease. Palliative patients typically receive this care alongside their curative treatments. They may need more or less palliative care as their disease subsides or progresses.
When Is It Time For Palliative Care?
Palliative care can be appropriate for anyone at any stage of a serious illness. There are no restrictions by age. The need for palliative care may change as the disease changes. For some patients, treatments cure their illness, and they no longer need palliative support. For others with chronic illnesses, the need for palliative care changes with the disease.
There is no definitive list of illnesses or conditions appropriate for palliative care. However, these are some of the diagnoses people may have when they begin palliative treatments:
- ALS (Lou Gehrig’s disease)
- Alzheimer’s disease
- Cancer
- Chronic obstructive pulmonary disease (COPD)
- Dementia
- Heart Failure
- HIV/AIDS
- Kidney disease
- Liver failure
- Multiple sclerosis
- Parkinson’s disease
- Stroke
One of the most important things to remember about palliative care is that there is no need to wait. Your loved one does not have to be very sick. They do not have to wait and only receive advance palliative care. Palliative care teams often begin working with patients right after a diagnosis.
If your loved one has been sick for some time, consider palliative care. These are some of the signs they could benefit from it:
- Their symptoms, including pain, have gotten worse.
- They’re not coping as well with symptoms as they have in the past.
- Symptoms or side effects of treatment prevent them from doing normal activities, socializing, or managing day-to-day.
- They’re struggling mentally or emotionally with being sick.
- Caregivers and family members struggle to keep their loved one comfortable and functioning.
If your loved one’s doctor has not mentioned palliative care, ask about it. There is no reason to wait when they could benefit. A palliative care team includes a primary physician and several other types of healthcare professionals. They provide:
- Treatments, therapies, and medications to manage pain and other symptoms.
- Emotional support and mental health care.
- Information and resources for the patient, their family, and their caregivers.
- Care coordination to ease the burden of navigating health care systems.
- Legal and financial resources and guidance.
- Spiritual support.
When Is It Time For Hospice Services?
Choosing hospice care is difficult for patients and their families. Misconceptions often prevent patients from getting hospice care when they really need it. These are some of the myths people believe about hospice:
- Entering a hospice program means my loved one will die within days.
- Hospice speeds up the dying process.
- The hospice team will just give my loved one morphine.
- Hospice care teams will take the control out of the hands of the patient and their families and caregivers.
- It always takes place in a hospice facility, so my loved one will have to leave home.
These misconceptions are unfortunate because they delay beneficial services. Hospice focuses on keeping a patient comfortable for the time they have left. It is individualized care that may include pain management, therapy, counseling, and spiritual guidance. Hospice also helps family members and caregivers.
Your loved one’s physician can help you determine the right timing. Care providers generally suggest it when they expect your loved one to live six months or less. Six months is when Medicare hospice benefits begin.
You don’t have to wait until your loved one’s doctor suggests hospice. If you or your loved one believe it may be time, talk to their medical team. Regardless of the Medicare insurance coverage guideline, a patient can self-refer to hospice care.
There is no single way to determine when it’s time for hospice care. The decision should be made between the patient, their family, and their doctor. These are some signs and reasons to choose hospice:
- Curative treatments have been exhausted. They are no longer helping and are causing more pain or distress.
- Your loved one does not want to continue with medical treatments.
- Your loved one’s health and quality of life are declining rapidly. They’re in a significant amount of discomfort, pain, or distress. They may be losing weight or not eating very much.
- Family members and caregivers cannot keep your loved one comfortable. They are struggling to keep up with care and are getting burned out.
- Your loved one’s illness and symptoms are preventing them from enjoying any of the time they have left. They’re unable to spend any quality time with family or friends because of pain or other issues.
There are options if you decide to begin hospice care for a loved one. You can choose between home health care services, a hospice facility, or care in a residential facility or even a hospital. Consider your loved one’s preferences, financial costs, and practicalities.
Choosing to begin palliative medicine, and especially hospice care, is difficult. Many families struggle to make the right decision but rarely regret starting services. The sooner your loved one gets beneficial care, the sooner they will see an improvement in quality of life.
Check out the Trualta library for more resources on hospice, palliative care, and other topics related to caregiving. Use this link to find out if you have free access.
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