Palliative Care vs. Hospice: What's the Difference?

While the objective of both hospice and palliative care is pain and symptom relief, the prognosis and goals of care tend to be different. 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.

Palliative Care

Hospice

Eligibility

Palliative care is for people of any age and at any stage in an illness, whether that illness is curable, chronic, or life-threatening. If you or a loved one are suffering from symptoms of a disease or disorder, be sure to ask your current physician for a referral for a palliative care consult.

Specific to the Medicare Hospice Benefit, a patient is eligible for hospice care if two physicians determine that the patient has six months or less to live if the terminal illness runs its normal course. Patients must be re-assessed for eligibility at regular intervals in order to meet ongoing coverage criteria, but there is no limit on the amount of time a patient can be on the hospice benefit.

Treatment

Since there are no time limits on when you can receive palliative care, it acts to fill the gap for patients who want and need comfort at any stage of any disease, whether terminal or chronic. In a palliative care program, there is no expectation that life-prolonging therapies will be avoided.

Most hospice programs concentrate on comfort rather than cure. By electing not to receive extensive life-prolonging treatment, hospice patients and their families can concentrate on getting the most out of the time they have left, without some of the negative side-effects that life prolonging treatments can have.

Location

It is most common to receive palliative care through your physician’s office, home care services, hospitals or nursing homes. 

In most cases, hospice is provided in the patient’s home. Hospice care is also provided in freestanding hospice facilities, hospitals, or nursing homes. 

Timing

There are no time restrictions. Palliative care can be received by patients at any time, at any stage of illness whether it be terminal or not. Should the patient’s serious illness become terminal with a prognosis of six months or less, it may be appropriate to consider a referral to hospice care.

Now is the best time to learn more about hospice and ask questions about what to expect from hospice services. Although end-of-life care may be difficult to discuss, it is best for family members to share their wishes before it becomes a concer.

Payment

Most insurance companies cover both palliative care and hospice. Medicare coverage for palliative home care can be challenging as the patient must meet Medicare eligibility which includes being homebound or confined to the home. People with a serious illness may not be homebound as they try to maintain a quality of life including socialization outside the home.

For those on Medicare, there is a Medicare Hospice Benefit available for patients whose life expectancy is six months or less, as determined by their physician. Medicaid hospice coverage is the same as the Medicare benefit. Also, some commercial insurance companies also offer hospice coverage. If you are unsure of coverage, contact your insurance company.