Hospice Care versus Palliative Care
Many people think hospice care and palliative care are interchangeable terms for one program, which often results in these resources being underused. They do have many things in common and may be found within the same company, so it’s understandable to be confused about what sets them apart, but there are some important differences between them; understanding these differences will allow you to request these resources if you are in a position to need them.
Hospice care is medical care that focuses on the comfort and quality of life of a patient instead of focusing on curative treatment. To be eligible for hospice care a patient typically needs to have a life expectancy of 6 months or less. While on hospice, a patient cannot be receiving curative treatment; for example, a patient cannot be undergoing chemotherapy and be on hospice care. There are some important things to note about hospice care:
The condition that a patient is not receiving curative treatment pertains to the disease that has lead to the 6-month life expectancy. This does not mean that they cannot receive any care for chronic illnesses. For example, a patient with lung cancer, hypertension, and diabetes cannot be undergoing chemotherapy but will still get treatment for hypertension and diabetes if they want this.
Hospice care focuses on symptom control and improving quality of life; choosing this option does not mean the patient will be in pain as that is actually the opposite of what hospice care aims to do.
Some programs teach family/loved ones how to care for the patient and what to do in emergent situations (this is important because our reflex is to call 911, but if someone is in hospice care this is not necessarily the best first step).
They provide support with emotional aspects of death and dying and many programs provide bereavement support.
The goal of hospice is not to hasten death but to focus on comfort and quality of life.
Palliative care is medical care for individuals with chronic and/or serious illnesses; this care focuses on improving the patient’s quality of life even if they are receiving curative treatment. In fact, palliative care has been shown to provide higher care at a lower cost; this is in part because it ensures that resources are being used in conjunction with patient needs and wants (“The Case for Palliative Care”). Unlike hospice care, there does not need to be the expectation of death within a certain time period to qualify. I think of palliative care as supplemental care with a whole-person view. Important things to note about palliative care:
Patients can continue active treatment of their disease while being on palliative care.
Palliative care is available regardless of life expectancy or prognosis.
The palliative care team works to clarify your goals and determine a plan of care that aligns with those goals.
The palliative care team can help navigate treatment options and provide community referrals.
These programs can often help the patient advocate for what they want when discussing treatment with other members of the care team.
Physical, emotional, social, and spiritual issues can be addressed by the interdisciplinary palliative care team.
Unfortunately, even within the medical community, there is the view that palliative care = hospice care = “giving up”. As you can see from the above information, palliative care and hospice care, while similar, provide care in different situations. If you or a loved one want palliative care as part of your care team this is your right, even if providers on your care team push back.
References
https://medlineplus.gov/ency/patientinstructions/000536.htm
https://getpalliativecare.org/whatis/faq/
https://39k5cm1a9u1968hg74aj3x51-wpengine.netdna-ssl.com/wp-content/uploads/2019/04/PalliativeCare_VS_Hospice.pdf
https://www.capc.org/the-case-for-palliative-care/