What’s the Difference Between Hospice and Palliative Care?

Understanding care options in difficult times

Many sick individuals pass away in long-term care facilities or hospitals. Others, however, receive care in the comfort of their own homes. Perhaps you’re wondering how to ensure comfort and dignity for your loved one’s last months or years. Or maybe you’re trying to understand care options after a life-changing diagnosis.

Both palliative care and hospice care exist to help people with a severe illness feel better. But what are the differences? And how do you determine your eligibility?

Below, senior care expert Jeffrey Landsman, MD, and palliative nurse practitioner Tara Simpson, both of Mercy Medical Center in Maryland, weigh in on hospice care and palliative care, explaining the differences between the two.

What is palliative care?

The National Institute on Aging (NIA) describes palliative care as medical care meant to improve a person’s quality of life.

Palliative care soothes suffering by treating symptoms such as nausea, pain, and even depression or anxiety related to your sickness. A key benefit of palliative care is that you can receive it while the disease is still being treated.

However, Dr. Landsman says that unlike hospice, palliative care usually doesn’t fall under a patient’s health insurance benefits. Instead, “palliative care” is a general term for any physical or emotional care plan that’s developed to ease suffering.

What is hospice care?

Hospice care, on the other hand, is end-of-life care—”a Medicare benefit that provides palliative care for terminally ill patients,” Simpson explains.

To receive hospice care your doctor must certify that you are expected to live no longer than six months. Hospice also requires halting any treatments aimed at curing the sickness. In hospice care, the goal is a dignified death rather than disease reversal. (Get more information in 8 Signs It’s Time for Hospice Care.)

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Similarities between hospice and palliative care

Hospice is a very specific type of palliative care. Both are to improve quality of life during a difficult, even heartbreaking time.

Here are three key similarities:

Both need a diagnosis

Not just anyone can walk into a hospital and request palliative care. To be eligible for palliative care, including hospice, a patient must have a serious illness.

Both include home or inpatient help

According to the National Institute on Aging, hospice and palliative care can each take place in several settings:

• home
• hospital
• assisted living
• nursing home facility

Both offer physical and emotional support

“Palliative care and hospice focus on comfort and providing patients with relief from the symptoms, pain, and stresses of a serious illness,” Simpson says.

According to the National Hospice and Palliative Care Organization (NHPCO), both types of care involve an entire team of helpful professionals. Your team could include a doctor, nurses, a social worker, a chaplain, and more.

Differences between hospice and palliative care

There are two major differences between hospice and palliative care.

Curative intent

Palliative care can work hand-in-hand with treatments aimed at curing your disease. Hospice, on the other hand, cannot. “You’re not looking to reverse the disease,” Dr. Landsman explains about hospice.

When a patient chooses hospice care and this course of treatment is approved by insurance, their care team shifts from addressing the disease to instead addressing the symptoms. Hospice means pursuing a dignified, comfortable death. That’s why this end-of-life care is only available to patients with terminal illnesses such as cancer, heart disease, progressive dementia, or amyotrophic lateral sclerosis (ALS).

Life expectancy

Hospice is for patients with six months or less to live, Simpson says. This isn’t an arbitrary measurement.

For you to qualify for hospice care through Medicare, your doctor must put this in writing. Palliative care, on the other hand, includes no such stipulation. Any severely ill person can receive palliative care to supplement their disease treatments.

Cost of hospice vs. palliative care

The cost of palliative or end-of-life care could change depending on your insurance coverage. In general, Medicare-certified hospice care should be free of charge. Sometimes Medicare or Medicaid also cover palliative care, according to the NHPCO.

State Medicare stipulations and private insurance coverage vary, so it’s always best to consult with your medical team. Your doctor can help you anticipate out-of-pocket expenses based on your needs.

Hospice vs. palliative care: How to decide which is right for you

Remember, hospice care is not an option unless the patient has a terminal diagnosis and a life expectancy of six months or less, as determined by their physician. All other scenarios revert to palliative care for comfort and symptom management.

The main thing to know is this: palliative care can help if you are, or a loved one is, suffering due to a severe illness.

If you or someone you love is terminally ill with less than six months to live, you may want to talk to your doctor about Medicare-certified hospice. Choosing hospice can be a difficult and emotional decision. But if death is imminent, hospice can be an incredible benefit to patients and their families, Dr. Landsman says.

Once hospice care begins, the Medicare benefit typically covers everything necessary to stay comfortable until the end.

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