Hospice and palliative care are often misunderstood and used interchangeably, but they are two different types of medical care. Both aim to put the care recipient first and address the care recipient’s needs to enhance their quality of life. However, we’ll discuss important key differences in who is appropriate, when they should begin, and the type of care provided.

Check out the Trualta library for more resources on palliative care, hospice, and other topics related to caregiving. Use this link to find out if you have free access. 

What Is Palliative Care? 

Palliative care is specialized patient-centered medical care provided alongside the care someone is already receiving for their condition or diagnosis. 

It’s a holistic approach focused on:  

• Improving the care recipient’s comfort
• Minimizing pain 
• Relieving the care recipient’s symptoms
• Enhancing quality of life
• Providing the care recipient with control and agency in their healthcare journey 

Having palliative care providers on the medical team does not mean that someone is nearing the end of their life—that is a misconception. Palliative care can occur at any point during the individual’s journey and can be provided alongside curative treatments and interventions.

What Types Of Support Does Palliative Care Provide?

Palliative care providers assist with multiple components of an individual’s medical care and work alongside current providers to optimize their comfort. Palliative care services can be thought of as a wheel with multiple spokes, all of them working together to provide comfort to the patient along their journey. Some of the major components of palliative care include:

Pain & Symptom Management

One of the primary roles of palliative care is addressing the care recipient’s pain and comfort. Providers will make recommendations for pain management to best address the discomfort associated with the illness. 

Examples of this include: 

• Working with primary doctors to choose the best pain medications for the person
• Providing mindfulness and breathing techniques to assist with pain control
• Recommendations for sleep and nutrition to help address discomfort and fatigue

Psychological & Emotional Support

Another way to assist with comfort and improved quality of life is to provide support for the mind. Palliative care providers can help recommend supports like psychologists and anti-anxiety medication and can assist with counseling stressors associated with a chronic illness. By having this safe space to reflect on feelings and talk through concerns, the care recipient can feel heard and process this challenging time.

Education & Advanced Care Planning

Another role that palliative care provides is collaborating with the care recipient and family on their goals of care. This can include supports like: 

• Educating the care recipient and family on the diagnosis
• Discussion of anticipated prognosis
• Exploring different treatment options and deciding on the ones that align with the care recipient’s values 
• Determining which advanced interventions the care recipient does and doesn’t want (for example, use of a ventilator or getting CPR and a shock if needed) 

Spiritual Support

Honoring the care recipient’s spiritual and faith preferences is another support that palliative care can provide. A chaplain, minister, or spiritual advisor is often part of the palliative care team and is available to have conversations and provide support to care recipients.

Familial & Social Supports 

The palliative care team can provide support to the care recipient, their families, and their caregivers as they all navigate a new condition and the experiences and frustrations that come with it. Some ways that palliative care can provide social support include: 

• Providing community resources and community support groups
• Supporting families through the emotional strain of having a loved one with a difficult condition via mindfulness techniques, relaxation strategies, or talk therapy
• Providing a safe space for family members to discuss goals of care and plan for the future of the care recipient

Who Provides Palliative Care? 

The palliative care team consists of multiple healthcare providers who collaborate to best serve the care recipient. While there is often a primary palliative care doctor who oversees and guides care, each healthcare professional communicates with each other to address the care recipient’s needs. 

Palliative care teams can consist of:

• Doctors
• Psychologists
• Social workers
• Physical and occupational therapists
• Chaplain or priest
• Dieticians
• Speech therapists
• Nurses

Who Should Receive Palliative Care? 

Anyone with a chronic and serious illness that interferes with their quality of life. Palliative care can be initiated at any point in the diagnosis and is not restricted to only end-of-life care. 

Two examples of individuals who would benefit from palliative care include: 

• A patient who has a diagnosis of cancer who is fatigued, has a loss of appetite, and sleep disturbance due to chemotherapy treatment
• Someone with heart failure who lives alone and experiences frequent hospitalizations due to shortness of breath, fatigue, and swelling

What Is Hospice Care? 

Hospice care, also sometimes called “comfort care”, is a type of palliative care treatment specifically for individuals who have a terminal diagnosis and are nearing the end of life. A care recipient will choose to transition to hospice when their life limiting illness has progressed, and they are no longer receiving curative treatment. 

The difference between palliative care and hospice is that in hospice care, all curative treatments are stopped, and the focus is on the patient’s dignity and comfort as they approach their final months, weeks, or days.

What Type Of Support Does Hospice Care Provide? 

Hospice care services provide supportive care to the patient and family to ensure a comforting end of life. These supports are similar to those described in the palliative care section of this article, and can include: 

• Pain and symptom management. The primary goal of hospice is to address any discomforting symptoms (like nausea, anxiety, and shortness of breath) and address pain to make sure the patient is comfortable as they near the end of their life. 
• Emotional support. The hospice team is skilled at helping patients and families cope with and process thoughts and feelings that come with the process of a loved one progressing toward death. They’re available to validate and talk through feelings to help families and care recipients work through their complex emotions.
• Equipment. A care recipient may have progressed to the point of needing a walker when moving around or needing a hospital bed with railings to sleep in. Hospice assists with getting any and all equipment needed to ensure the care recipient is comfortable at home. 
• Education to caregivers. Hospice providers can train family members with care tasks like mobility, understanding their medications, and using equipment. 
• Grief and bereavement support. For family members of the care recipient, hospice services may provide grief counseling, connections to support groups, and follow-up calls to check in on the family after the loved one has passed.

Who Provides Hospice Care? 

The hospice team is made up of individuals specifically trained to care for those in the final months or weeks of life. These professionals may include: 

• A hospice physician
• Hospice nurses
• Social workers
• Therapists
• Hospice aides
• Bereavement specialists
• Volunteers
• Chaplains and spiritual counselors

Who Can Receive Hospice Care? 

Hospice care is provided to individuals in their last 6 months of life. Anyone with a terminal diagnosis that has a life expectancy of 6 months or less can receive hospice care.

Where Can Hospice Care Take Place? 

Hospice is most often provided in any place the care recipient calls home, including the care recipient’s place of residence or a nursing facility. In some cases, when the passing of the care recipient is imminent, hospice care services can take place right in the hospital or in a hospice facility where loved ones can be present with the patient as they progress toward the end of their life peacefully. 

To learn more about hospice and palliative care, check if you have access to Trualta’s learning library. 

References

1. National Institute on Aging. (2020, November 17). What are palliative care and hospice care? National Institute on Aging. https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care
2. Cleveland Clinic. (2023, October 23). Palliative care. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22850-palliative-care
3. Caregiver Action Network. (n.d.). Understanding palliative/supportive care: What every caregiver should know. Caregiver Action Network. https://www.caregiver.org/resource/understanding-palliativesupportive-care-what-every-caregiver-should-know/
4. Cleveland Clinic. (2023, October 23). Hospice. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/21673-hospice
5. Samaritan Healthcare & Hospice. (n.d.). Hospice pain management. Samaritan Healthcare & Hospice. https://www.samaritannj.org/hospice-blog-and-events/hospice-palliative-care-blog/hospice-pain-management/
6. VITAS Healthcare. (n.d.). What’s expected of a hospice patient’s primary caregiver. VITAS Healthcare. https://www.vitas.com/family-and-caregiver-support/caregiving/caregiving-basics/whats-expected-of-a-hospice-patients-primary-caregiver
7. VNS Health. (n.d.). Who’s who on your hospice care team. VNS Health. https://www.vnshealth.org/patient-family-support/health-library/whos-who-on-your-hospice-care-team/