Hospice and palliative care both aim to minimize suffering from serious illnesses. They honor the values and wishes of the individual and preserve human dignity.
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In this article, we provide more detail on the similarities and differences between hospice and palliative care.
Both palliative care and hospice care aim to reduce discomfort and pain, honor a person’s values, support the family, and offer individualized care. According to the
- Both offer medications to help ease pain and other burdensome symptoms.
- They offer more than medical care, providing access to chaplains, social workers, and other experts to help coordinate care.
- They include the family in the care of the person, involving them to the extent that the person wishes. They also offer support services, such as grief counseling and illness support groups, to family members.
- Both can happen in a variety of settings, including a home, hospital, or long-term care facility. However, people seeking palliative care usually get care where they are receiving treatment.
People receiving palliative care may eventually become eligible for hospice care. For example, a person with cancer who is undergoing active treatment may also receive palliative care for symptom management and support throughout the course of their illness. If the cancer progresses or does not respond to treatment, and the person’s condition declines, they may become eligible for hospice care.
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People who choose palliative care may have a terminal illness or be near the end of life. However, this is not always the case, and some people receiving palliative care recover from their illness.
Hospice care is exclusively for people who have a terminal illness and are approaching the end of their life. In most cases, a person is only eligible for hospice care when their estimated life expectancy is 6 months or less. Other key differences between hospice care and palliative care include:
- Treatment: A person receiving palliative care may continue to have curative treatment, such as chemotherapy or surgery for cancer. Hospice care is for people who no longer want treatment or whose illness has stopped responding to treatment.
- Prolonging life: People receiving palliative care may continue to pursue aggressive measures to preserve and prolong their life, whereas those in hospices usually elect to avoid such measures. For example, a person with advanced cancer who develops an infection might choose not to treat the infection because they want to avoid the hospital and would prefer to be at home when they die.
- Length of eligibility: People are eligible to receive palliative care for as long as they have a life threatening or life limiting illness. Hospice eligibility continues for as long as a medical director can certify that if a person’s disease follows its expected course, their life expectancy is 6 months or less.
- Medical team: Palliative care does not replace treatment from the person’s usual medical team. Conversely, hospice care usually does, although a person may still see their primary care physician.
- Period of care: Palliative care happens on an as-needed basis, so a person may only get it
intermittently when their symptoms warrant more support. A hospice offers ongoing care until a person dies. A person in a hospice may also continue to receive specialty care for other illnesses that they may experience.
(Video) Palliative Care - How is palliative care different from hospice care?
There are two forms of hospice and palliative care eligibility:
Eligibility for insurance coverage
Many insurance plans, including Medicare and Medicaid, offer some coverage for both hospice and palliative care. However, coverage amounts and eligibility vary. In most cases, a person is only eligible for hospice care if their life expectancy is 6 months or less. A doctor must certify that they are terminally ill and have a short life expectancy.
However, if a person lives longer than this, their insurer may continue paying benefits, depending on the terms of their policy.
A person is eligible for palliative care if they have a serious illness such as cancer. However, the willingness of the insurer to cover care depends on the terms of the policy. There is no time limit on palliative care.
Provider-specific eligibility
Hospice and palliative care professionals usually conduct an evaluation to assess whether a person is a suitable candidate. In some cases, the assessment involves determining whether hospice or palliative care is more appropriate. Factors that may influence the outcome of an evaluation include:
- what insurance will cover
- the specific diagnosis and whether it is a terminal condition
- a person’s life expectancy
- how limited a person is in their daily activities
- the wishes of the person and their family
(Video) Hospice or Palliative Care: What's the Difference?
Medicare and Medicaid both cover palliative care. However, a person may have to pay a copay, and their plan might not fully cover some medications.
Medicare typically pays all costs associated with hospice care, with the possible exclusion of some drugs. In most states, Medicaid offers similar full coverage, but it is important to check state Medicaid rules to gauge the out-of-pocket expenses.
For people with private insurance, coverage varies from insurer to insurer. If the coverage is insufficient, a person can check their eligibility for Medicare or Medicaid.
In most cases, the choice between hospice and palliative care depends on the specifics of a person’s illness and situation rather than their personal preference. For example, a person is not eligible for hospice care if they do not have a terminal illness or are undergoing curative treatment for a chronic illness.
A hospice may be the best choice if a person:
- has a terminal illness
- is likely to live less than 6 months
- is no longer pursuing disease-directed treatment
Palliative care may be the best choice for a person who:
- has a serious or life threatening illness with an uncertain trajectory
- has a life expectancy longer than 6 months
- is still pursuing aggressive treatment aimed at curing or treating the illness
Some questions that a person may wish to ask when considering hospice or palliative care include:
- What will my insurance cover?
- What evaluations do I need to undergo to be eligible for coverage?
- What documentation do I need to provide?
- What specific services am I eligible for?
- If I get palliative care and later need hospice care, can I get it from the same treatment team?
- What happens if I enroll in hospice and live longer than 6 months?
- Who should I call if there is an emergency or if I feel unsatisfied with the care I get?
- Can I choose my healthcare team or give certain criteria, such as a preferred gender?
(Video) Palliative care does not equal hospice
Both hospice and palliative care can help an ill person and their family cope with the many aspects of a serious disease, including managing pain, handling family conflict, and resolving spiritual and cultural issues.
Facing the decision between the two types of care can be difficult, especially when a person is terminally ill, but a doctor can help guide the process and suggest the most suitable option. The right hospice or palliative care provider can also offer an evaluation that determines which choice is the best fit for a person’s needs and treatment goals.
FAQs
Is palliative care more expensive? ›
The cost of palliative care can vary depending on the setting in which it is provided. The average cost of palliative care is estimated to be around $95 / day for in-home care. According to the National Institute of Health, the average cost per hospital patient receiving palliative care was $32,643 per admission.
Does palliative care reduce healthcare costs? ›Conclusion: This study demonstrates that palliative care has the capacity to substantially reduce healthcare expenditure among advanced cancer patients. Earlier palliative care consultation results in greater cost reductions than consultation in the last week of life.
What do hospice and palliative care have in common? ›Hospice and palliative care both offer relief from the pain and symptoms of a serious illness. They also address the emotional, social and spiritual needs of patients and their families. In fact, hospice is a type of palliative care for people at the final stages of life.
What is palliative care and how is it related to hospice care how does it differ from the treatment given by most acute care hospitals? ›The Difference Between Palliative Care and Hospice
Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.
Hospice care is free, so you don't have to pay for it. Hospices provide nursing and medical care. Whether you stay in the hospice depends on your situation. You may stay at a hospice for a few days or weeks while you need specialist care, and then return home.
What's the difference between hospice and palliative care? ›Palliative Care vs Hospice Care
Hospice is comfort care without curative intent; the patient no longer has curative options or has chosen not to pursue treatment because the side effects outweigh the benefits. Palliative care is comfort care with or without curative intent.
Estimates range from $150 for at-home care to $500 for inpatient care. Some hospice care costs are covered by Medicare, including medical services and supplies, physical therapy, short-term inpatient care, and inpatient respite care.
What is the hospice interdisciplinary team? ›The members of this interdisciplinary team include a physician, nurse, hospice aide, social worker, chaplain, volunteer and bereavement specialist.
What causes dyspnea at end of life? ›This Fast Fact reviews key elements in the assessment and treatment of dyspnea near the end-of-life. Etiology The causes of dyspnea include a wide spectrum of serious lung or heart conditions, anemia, anxiety, chest wall pathology, electrolyte disturbances or even urinary retention or constipation.
What are the 3 forms of palliative care? ›- Medication.
- Nutritional changes.
- Relaxation techniques.
- Emotional and spiritual support.
- Support for children or family caregivers.
Can you switch from hospice to palliative care? ›
Hospice is about choice. You get to choose what you want to do and your hospice team helps make that happen. You can start with supportive or palliative care and move to hospice. You can go back to palliative care if you want to try a new treatment.
Does palliative care include bathing? ›Caregiving may include lifting, bathing, delivering meals, taking loved ones to doctor visits, handling difficult behaviors, and managing medications and family conflicts.
Who pays for palliative hospice care? ›Who pays for palliative care? Palliative care is often covered by Medicare, Medicaid and most private insurance. Every financial situation is different in regard to who pays for palliative care, so we recommend you contact your insurance company to find out about any possible copays or deductibles.
Why do doctors recommend palliative care? ›It provides relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a specially-trained team who work together with your other doctors to provide an extra layer of support.
How long do hospice patients live without eating? ›Considering the many variables, people may wonder how long someone can live without food in hospice. As a result of discontinuing eating, patients can die in as early as a few days. For most people, this period without food usually lasts about 10 days, but in rare instances, it can last several weeks.
How Long Will Medicare cover palliative care? ›Palliative care coverage can extend for as long as you need hospice care. Qualification requires having a life expectancy of six months or less. If the beneficiary is still alive after six months, hospice and palliative care coverage may continue if the patient is re-certified as terminally ill.
Do you have to pay for palliative care in a nursing home? ›It's available to people who have certain types of health and care needs. It is free of charge to the person receiving the care.
Why is end-of-life care so expensive? ›When it comes to the end of life, hospital stays are more intensive and more expensive than alternatives. People who die in the hospital undergo more intense tests and procedures than those who die anywhere else.
When should someone be offered palliative care? ›Palliative care should be offered when someone has a life-limiting condition or chronic illness and they need intensive treatment to either ease the pain and manage the condition or cure the condition completely.