Hospice Care? or Palliative Care? What is the difference?  Which is best?

When facing a serious illness, understanding your care options can feel overwhelming. While 'palliative care' and 'hospice care' are often used interchangeably leading to confusion about what each entail and who they are meant to help. Understanding the distinctions between these two types of care is crucial for patients and families navigating the complex landscape of healthcare options. While both focus on enhancing quality of life, they serve different purposes and meet different needs. In this article, we’ll explore the unique features of palliative and hospice care, clarifying the eligibility requirements and discussing how each can provide comfort and support during some of life’s most challenging moments.

To make the best decision for yourself or a loved one, it's essential to understand the specific goals, benefits, and eligibility requirements of each type of care.

Firstly, a quick definition: Palliative and hospice offers specialized support for patients and families dealing with serious illnesses.

Palliative Care: The focus of palliative care is to provide specialized medical support aimed at enhancing the quality of life for patients with serious, life-threatening illnesses. It prioritizes symptom relief, pain management, and emotional support for both patients and their families, regardless of the stage of the disease. Palliative care can be integrated with curative treatments and is appropriate at any stage of a serious illness. Palliative care can also help you cope with side effects from medical treatments. Palliative care is available for patients diagnosed with serious conditions including cancer, heart disease, respiratory diseases. Palliative care can be provided at any stage of the illness, from diagnosis onward. Patients typically need a referral from a healthcare provider.

A palliative care team conducts an assessment to understand the patient's physical, emotional and spiritual needs. A palliative care team is made up of many different professionals that provide medical, social, emotional, and practical support. The team can be comprised of specialist doctors and nurses, social workers, nutritionists, and chaplains. Palliative care is generally covered by Medicare and private insurances, but you will want to check with each to verify eligibility.

Studies show that those that enroll in palliative care have fewer symptoms, greater emotional support, and increased patient and family satisfaction. Also, patients can enter and leave palliative care. 

Hospice Care: Hospice care, in contrast, is specifically designed for people with terminal conditions. The focus of Hospice care is the care, comfort, and quality of life. Hospice care is provided when the patient's doctor believes he or she has six months or less to live if the illness runs its natural course. A physician's referral is generally required. The patient must decide to forego further treatment options and focus on comfort care instead.  While hospice stops treatments aimed at curing the illness, patients can continue to receive other medical care such as treatments for high blood pressure. 

A Hospice care team may consist of a team of nurses, doctors, social workers, spiritual advisors and trained volunteers. Together they provide the medical, emotional and spiritual support. The team visits regularly and sometimes usually always available by phone- 24 hours a day, seven days a week. It's important to discuss hospice care with the patient's doctor. Sometimes people don't begin hospice soon enough to take full advantage of the help it offers. Hospice may be covered by Medicare and other insurance companies, but you will want to check with each to verify eligibility.

Starting hospice early may be able to provide months of meaningful care and quality time with loved ones. Families of people who receive care through a hospice program are more satisfied with end-of-life and quality time with loved ones. Hospice recipients are more likely to have their pain controlled and less likely to undergo test or be given medicines they don't need, compared to people who don't use hospice.

Extra Resources

• National Hospice and Palliative Care Organization (NHPCCO) ~ NHPCO.ORG
• Center to Advance Palliative Care (CAPC) ~ CAPC.ORG
• Hospice Foundation of America (HFA) ~ HOSPICEFOUNDATION.ORG

Books

1. "Being Mortal: Medicine and What Matters in the End" by Atul Gawande

2. "The Four Things That Matter Most: A Book About Living" by Ira Byock

Local Resources

• Local Hospice Providers: Many areas have hospice organizations that offer community resources, support groups.
• Health Care Providers: Ask your primary care doctor or oncologist about local palliative care programs or hospice services.

Conclusion

Understanding the distinctions between hospice and palliative care is crucial for patients and their families as they navigate the complexities of serious illness. While both approaches prioritize comfort and quality of life, palliative care is available at any stage of a serious illness and allows for curative treatment, whereas hospice care is specifically designed for those nearing the end of life, focusing on comfort and support without curative intent. By being informed about these options, patients can make empowered decisions that align with their values and goals. Open communication with healthcare providers, family, and caregivers is essential to ensure that the chosen care approach meets the patient’s needs, ultimately fostering a supportive environment during one of life’s most challenging journeys. With the right resources and a compassionate care team, individuals can find solace and dignity in their experience, no matter where they are on their health journey.

Questions

• What fears or concerns do you think someone entering hospice or palliative care would have, and how can they be addressed?
• How can technology and telehealth improve access to hospice and palliative care services for patients in remote or underserved areas?
• What factors do you think would influence your decision to enter hospice or palliative care? What information do you think would be helpful to make that decision.

Share your thoughts below