Palliative Care vs Hospice – What’s the Difference (and Right for Your Loved One)

Palliative care and hospice care share several similarities. They’re both patient-centered types of care that address quality of life and pain management.

However, there are key components that distinguish palliative care from hospice care. It’s important to know the differences between the two so that you or your family member or loved one receives the best care possible.

Palliative Care vs. Hospice

The first main difference between palliative care and hospice care is eligibility. Palliative care is available to patients in all stages of a serious illness. Hospice care is end-of-life care. 

The focus of palliative care’s pain management is to help patients live the best they can with their illness in their daily lives. Hospice care’s pain management focuses on helping patients live as comfortably as possible and have a peaceful passing. 

Both palliative care and hospice involve a team of people to care for a patient. However, hospice care tends to rely more heavily on family caregivers and hospice nurses to care for the patient.

Palliative CareHospice Care
GoalImprove quality of life while living with (or treating) serious illnessPain reliefSymptom reliefEmotional supportProvide end of life care to make the patient comfortable
EligibilityAnyone with a serious illness at any stageHospice patients must have a terminal illness and:Have a life expectancy of less than 6 monthsIndications that treatment is not working 
Care teamHolistic care including:Doctors Registered nursesTherapistsDieticians ChaplainsOther specialists Holistic care including:Hospice medical directorCase managersDoctors Registered nursesTherapistsDieticians Chaplains Other specialists 
Medicare coveragePartially coveredCovered
Care locationLocation is based on patient’s preferences – hospital, home, assisted living facility, etcLocation is based on patient’s preferences – hospital, home, assisted living facility, etc

Palliative Care

Let’s look at what’s involved in palliative care.

What is Palliative Care?

Palliative care is for people diagnosed and living with serious illnesses such as cancer, kidney disease, Parkinson’s, congestive heart failure, or Alzheimer’s. It focuses on improving people’s comfort and quality of life as they live with their chronic illness. Palliative care can be provided alongside curative medical care to treat the patient’s diagnosis. 

Read more: What is Palliative Care

Who is Palliative Care for (and Eligibility Requirements)?

Palliative care is for people living with serious illnesses. Anyone at any age and stage of an illness can request a palliative care consultation to improve their quality of life to reduce symptoms, pain, and discomfort.

Related: 5 Stages of Palliative Care 

When to Choose Palliative Care

People don’t have to wait for an illness to reach an advanced stage before requesting palliative care. Palliative care also doesn’t just alleviate pain. It’s a holistic approach that supports all needs in a person’s life, such as emotional support, spiritual, and social needs. 

Related: When Should Someone Go On Palliative Care

What Does the Palliative Care Team Look Like?

It takes an interdisciplinary team to provide palliative care. This team has a palliative care consultant. A palliative care consultant is a doctor who specializes in caring for patients with serious illnesses. 

The team can also include other health care professionals, including nurses, occupational therapists, dieticians, and psychologists. 

It’s also common to see social workers and counselors on these teams to assist with other needs that aren’t medically related. 

What Types of Care are Provided with Palliative Care?

The type of care someone receives through palliative care will vary, depending on individual needs. Some types of care include the following:

  • Medication management
  • Nutrition and diet
  • Physical therapy
  • Emotional support and services
  • spiritual support for religious needs
  • Support groups for families
  • Medical finance education

How Much Does Palliative Care Cost?

Care costs vary depending on the types of care and services an individual receives. That said, the majority of the care costs are paid for by Medicare, Medicaid, and other government programs.

Private insurance may also cover some costs associated with palliative care, so individuals should speak with their insurance companies for more coverage information. 

More Details: How Much Does Palliative Care Cost

Does Medicare Cover Palliative Care?

Yes, Medicare covers some palliative care costs for an older person seeking help with pain management through palliative care. Generally 85% of end of life care costs are covered by Medicare and Medicaid. 

Medicare Part A covers the following:

  • Inpatient hospital stays
  • Short-term stays at a skilled nursing facility
  • Limited home healthcare
  • Hospice care

Medicare Part B covers the following:

  • Doctor’s visits for related illnesses
  • Medical equipment
  • Mental health counseling
  • Outpatient rehabilitative therapy

Medicare Part C, or Medicare Advantage, must cover the same requirements as Original Medicare.

Medicare Part D can help cover the costs of prescription drugs that treat the symptoms related to a patient’s illness. 

There are some out-of-pocket expenses to consider even if someone has Medicare. These expenses can include insurance premiums, deductibles, copayments, and coinsurance. 

Deductibles for Medicare Part A and Medicare Part B are about $1,600 combined. Coinsurance may be up to 20%, depending on the palliative care services provided.

Related: Does Medicare Pay For Palliative Care?

Where is Palliative Care Provided?

People can connect with palliative care through different avenues. They can request a referral from their primary care physician or request more information from their insurance companies. 

Many different facilities also offer palliative care:

  • Hospitals
  • Assisted living facilities
  • Nursing homes
  • Outpatient clinics
  • Hospices
  • The patient’s home

Hospice Care

Here’s an explanation of what it means to receive hospice care.

What is Hospice Care? 

Hospice care is for individuals diagnosed with a terminal illness. Terminal illness means that the illness is incurable, and the individual will expectedly pass from it. Therefore, the goal of hospice care isn’t to cure patients. 

Instead, hospice provides comfort care. It supports people to live the best that they can until the end of their lives. 

Who is Hospice Care for (and Eligibility Requirements)?

Unlike palliative care, individuals must meet specific requirements for hospice care eligibility. A hospice physician and another physician must certify that a patient’s life expectancy is six months or less if the illness runs its natural course, or combination of symptoms including:

  • Weight loss 
  • Difficulty swallowing
  • Inability to perform activities of daily living (ADLs)
  • Decreased cognitive or mental capabilities
  • Increased fatigue and sleep
  • Frequent hospitalizations or trips to the ER
  • Recurrent infections
  • Increased disease progression

After being referred to hospice, admission into hospice is dependent upon acceptance from a hospice medical director. Hospice patients’ eligibility will be reviewed after the initial 6 month period, and periodically after that.

When to Choose Hospice Care

It’s understandably challenging to discuss and decide if a loved one should receive hospice care. However, some factors can help determine if hospice care is the right course of action:

  • A physician determined that a patient has less than six months to live. 
  • Treatment is no longer effective, and the patient’s health is on a rapid decline.
  • The patient no longer wishes to pursue curative treatment.

As a reminder, hospice care isn’t about giving up on the patient. It’s compassionate care that empowers people to live the remainder of their lives with dignity and peace. 

What Does the Hospice Care Team Look Like?

A hospice care team is an interdisciplinary team with professionals who specialize in hospice and end-of-life care. It can include the following:

  • Doctors
  • Nurses
  • Hospice medical director
  • Case managers
  • Social Workers
  • Chaplains
  • Bereavement counselors
  • Home health aides

What Types of Hospice Care are Provided?

Medicare defines four levels of hospice care:

  • Routine home care
  • Continuous home care
  • General inpatient care
  • Respite care

Routine home care is basic day-to-day care provided to patients once they are in hospice.

Continuous hospice care is intensive care that patients receive when their symptoms start to require more attention. It’s also known as crisis care and can take place after a patient has a medical crisis.

Inpatient hospice care takes effect once patients have symptoms that they can no longer manage at home. This level of care aims to stabilize symptoms and alleviate pain.

Respite care is available for family caregivers to take a necessary break from providing care for their loved ones. 

How Much Does Hospice Care Cost?

Hospice care can cost several thousands of dollars a month out-of-pocket. However, many insurance companies provide coverage for hospice care. 

Patients can also check to see if they’re eligible for Medicaid, which will pay for the majority of hospice care.

Does Medicare Cover Hospice Care?

Yes, Medicare covers hospice care. Once hospice care begins, Medicare will cover the costs related to the terminal illness and related conditions if the hospice care provider is Medicare-approved. 

Where is Hospice Care Provided?

Individuals can find hospice care through independent hospice agencies. Some hospitals and care facilities also have hospice programs.

Patients can receive hospice care in their homes or at facilities. It depends on the patient’s preferences and the necessary level of care.

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