Palliative Care vs. Hospice Care

This article has been medically reviewed by Dr. Martin Duggan in 2021.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

The terms palliative care and hospice care are often used synonymously. However, while they have some overlap, they provide different frameworks of care. It’s important to understand these differences, especially if your loved one is experiencing pain or is near the end of life. 

Palliative care and hospice care both involve patients with chronic conditions. The difference between these two types of care depends greatly on whether the patient wants to receive treatment to cure their condition. 

Let’s clarify the differences between palliative care vs. hospice care by giving an in-depth look at them both.  

What’s the difference between hospice care and palliative care?

Hospice and palliative have slightly different focuses. Hospice care is a type of palliative care intended for patients who are in the final stages of their life. For this reason, treatment to cure an illness isn’t generally administered. Instead, relieving pain and symptoms is the primary role of hospice care. 

In contrast, palliative care is for patients with serious illnesses, including cancer, heart disease, and dementia. This care is also intended to relieve pain and symptoms, but can be provided within the framework of primary treatment. Like hospice care, it’s designed to improve the quality of life for the patient, regardless of the stage of illness. For this reason, palliative care doesn’t necessarily mean a patient is dying.

How do I decide between palliative care vs. hospice care?

When a patient with a serious illness decides to no longer receive treatment, or has only a few months left of life, hospice care will be recommended. The doctor will provide certification that the patient has 6 months or less to live, so that hospice care can begin. 

On the other hand, palliative care can be administered during any stage of the patient’s condition to relieve pain and give greater comfort. You can ask about palliative care as part of your primary treatment plan. 

About palliative care

Palliative care can be administered to any patient with chronic pain or conditions regardless if they are terminally ill or not. Common conditions may include ALS, cancer, dementia, heart disease, HIV, kidney disease, liver disease, lung disease, Parkinson’s disease, MS, stroke, and coma.

Generally speaking, palliative care can involve pain relief, diet adjustments, physical therapy, mental health services or spiritual guidance. For this reason, different types of palliative care are carried out by nurses, nutritionists, therapists, counselors, or even chaplains. 

Patient profile: Any patient with chronic pain or conditions who wants to improve comfort as they receive primary treatment. 

Terminal patient or general patient? Any patient, terminally ill or not.

Home or facility? Palliative care can be provided at home or in a care facility. 

Care provided: Pain relief, medication management, dietary counseling, physical and rehabilitation therapy, pain-related therapy (such as massage), and mental health services and/or spiritual guidance.

ADL care? Provided as needed.  

Staff contact: Daily contact with nurse and/or health aide, but the number of visits depends on the patient. 

Cost: Varies depending on the palliative care needed. Routine home care runs from $150-$200/day, while continuous home care costs much more at $965/day. 

Payment method: Any medical care is typically covered by Medicare, Medicaid, VA Aid and Attendance benefits, or private insurance. Other amenities, such as room/board for a care facility, will have to be paid privately.

Benefits: Improved quality of life, while accompanying primary treatment plan.

About hospice care

When an illness can’t be cured – or a patient chooses not to pursue treatment – hospice care is recommended. In general, hospice teams are dedicated to managing pain and symptoms, as well as providing other types of support. In a home setting, hospice care involves medical and nursing care, as well as aid to family caregivers. 

Patient profile: Terminal patients with chronic pain or conditions who want to improve comfort as they approach end-of-life. 

Terminal patient or general patient? Terminal patient.

Home or facility? Hospice care can be provided at home or in a care facility. 

Care provided: Pain relief, medication management, dietary counseling, physical and rehabilitation therapy, pain-related therapy (such as massage), ADL and homemaker services, respite care, mental health services and/or spiritual guidance, and bereavement care.

ADL care? Provided as needed.  

Staff contact: Daily contact with a hospice nurse, but the number of visits depends on the patient. 

Cost: Varies depending on the hospice care needed. Generally, $150/day for home care and $500/day for facility care. On average, Medicare spends $11,820.00 per patient on hospice care.

Payment method: Any medical care is typically covered by Medicare, Medicaid, VA Aid and Attendance benefits, or private insurance. Other amenities, such as room/board for a care facility, will have to be paid privately.

Benefits: Improved quality of life during end-of-life stage.

Example profiles of palliative care vs. hospice care

Let’s look at some example profiles of seniors who are deciding between palliative care and hospice care. These situations will help you better understand which is right for you. 

Situation #1: Sarah 

Sarah was recently diagnosed with multiple sclerosis (MS). She’s currently receiving treatment for her MS symptoms so she can live a near-normal life. However, she’s having joint pain and is also struggling with anxiety related to her new condition. She would like to get treatment to relieve her pain and accompany her primary treatment plan, as well as get some mental health counseling.

Best choice: Palliative care. Sarah could benefit from getting palliative care, including pain relief, medication management and mental health services. She’s not a terminal patient, so hospice care wouldn’t be appropriate.

Situation #2: Quinn

Quinn was diagnosed with pancreatic cancer a year ago. He has received several rounds of treatment including chemotherapy. However, the cancer has spread and his condition is getting worse. Even though he’s stopped treatment, he needs help with daily ADLs and is still suffering pain. The doctor has expressed that his life expectancy is now a few months. Quinn has decided against treatment in order to enjoy his last months of life with his kids and grandkids. 

Best choice: Hospice care. Quinn is a terminally ill patient who could benefit from hospice care such as pain relief and medication management, as well as spiritual and bereavement care for his family. He could also benefit from ADL care that hospice provides. 

Now that you have a sense of both palliative care and hospice care, let’s compare the two in greater depth.

Comparing differences between palliative care and hospice care

To help you understand the differences, we’ve created this comparison chart, so you can best find out which option fits best with your needs. 

Conclusion

As you make your decision about palliative care vs. hospice care, you should consider all these factors above. While they have some overlap, the two provide different frameworks of care. 

Remember palliative care vs. hospice care have a wide range of care providers. You can learn more about care options and other senior topics at My Caring Plan. Simply start your search for palliative care or hospice care near you by entering your zip code. 

Sources:

1. Hospice Care, Medicare.gov, www.medicare.gov
2. What are Palliative Care and Hospice Care, NIH, www.nia.nih.gov
3. Where do Americans Die?, Stanford School of Medicine, palliative.stanford.edu