Palliative and hospice care: What’s the difference?

There is often confusion between palliative and hospice care as they have historically been used interchangeably. Both provide comfort for a patient suffering from a disease – but they differ in important ways.

Making a decision on which to pursue can be difficult. In order to help you or a loved one learn more about palliative and hospice care, Enhabit Home Health & Hospice has outlined the differences between the two types of care below.

What is the difference between palliative and hospice care?

Palliative care

According to the National Hospice and Palliative Care Organization (NHPCO), palliative care is defined as care that works together with a patient’s primary treatment for a disease or illness.

Palliative care focuses on managing the pain, symptoms and stress of a serious illness. It works together with the curative treatment but does not replace the patient’s primary treatment. Palliative care also has no time restrictions, meaning that patients with any type of illness or life expectancy can receive it.

Many patients who are not quite ready for hospice, even though they qualify, might choose palliative care.

Hospice care

The NHPCO defines hospice care as care that focuses on the pain, symptoms and stress of serious illness during the terminal phase. The terminal phase is defined by Medicare as an individual with a life expectancy, or prognosis, of six months or less if the disease runs its natural course.

Unlike palliative care, the goal of hospice is to provide comfort and support because curative treatment is no longer working and a physician has certified a patient’s prognosis is six months or less. When someone chooses hospice care, they should be at a point when curative treatment is no longer the best option and they wish to focus on maintaining comfort and dignity at the end of life.

What services are provided in palliative and hospice care?

Palliative care

Palliative care can be provided in any care setting including hospitals, clinics, assisted living communities or at home. Wherever someone is receiving treatment for their illness, they can receive palliative care in the same setting.

Services include:

• Pain and symptom management
• Nurse visits either in-person or via telehealth
• Assistance with treatment options and education
• Advance care planning
• Additional referrals to community resources

Hospice care

Hospice care can be provided in most care settings, excluding clinics or doctor’s offices. Typically, one receives hospice care at home or in a home setting, such as an assisted living or skilled nursing facility. Hospice care can also be provided in hospitals.

Support from the hospice team comes in the forms of physical, social, emotional and spiritual services. Hospice care services include:

• Pain and symptom management
• 24-hour on-call nursing services
• Nurse visits to the home
• Medical equipment such as hospital beds, wheelchairs, bedside commodes, etc.
• Inpatient care in a hospice facility
• Continuous care in the home
• Medical social work
• Respite care for the patient’s loved ones
• Hospice volunteer services
• Spiritual care from a chaplain
• Bereavement services for loved ones for up to 13 months after a patient passes

Per the Center for Medicare & Medicaid Services (CMS), there are four different levels of hospice care. These levels include routine, inpatient, continuous and respite care. Click here to read more about the four levels of hospice care.

Does Medicare cover both palliative and hospice care?

Palliative care is covered through Medicare Part B and Medicaid. However, it is important to remember that some treatments or medications may not be covered and may require a copay.

The Medicare Hospice Benefit covers all related costs associated with hospice care. Medicaid also covers these services in most states. There may still be some medications, services or equipment not included in the Medicare Hospice Benefit.

Most private insurers will cover both palliative and hospice care as well. Each insurance provider is different so refer to your member benefits for more information.

Should I choose hospice or palliative care?

Choosing the type of care for yourself or for a loved one is a deeply personal decision that should be discussed with your physician.

Typically, physicians refer patients to palliative care if they have an advanced chronic illness that is being treated by the maximum medical therapies available. If patients choose palliative care, they can continue their same treatment, but with the assistance of pain and symptom management. This also allows them to leave the hospital and receive their care from wherever they call home.

In order to qualify for hospice care, a physician must certify that a patient has six or less months to live if the disease runs its natural and predicted course. Choosing hospice is relevant when the focus has shifted from treatment to comfort and pain management.

While hospice can be an uncomfortable topic to bring up with many misconceptions surrounding it, it’s worth learning about the benefits it can provide for patients and their loved ones.  

What type of care does Enhabit provide?

Enhabit provides high-quality, compassionate hospice care that helps bring dignity and support to patients and their families at the end of life. Enhabit doesn’t provide palliative care, but may be able to direct you to someone who can assist.

We want to help you with any questions you may have about hospice. Get the answers to your questions and the care you want and deserve by contacting us today.