Palliative Care vs. Hospice Care

At a recent palliative care conference, I learned that many individuals are unclear about the differences between palliative care and hospice, and some even confuse palliative care with palliative sedation. I wanted to take a moment to clarify these distinctions, aiming to ease any fear or confusion you might have. Additionally, I hope to illustrate a path that can help you or a loved one recognize that there is a plan in place during such challenging times, offering resources, support, and compassionate care tailored to the specific needs and stages of decline.

Palliative care offers comfort-focused care with the intention of providing relief from the symptoms and physical and mental stress of a serious or life-limiting illness. This is similar to hospice care as the intention is to reduce symptoms and suffering, however they differ in their timing and objectives. Palliative care can be used at any stage of a serious illness, whether terminal or chronic, and can be stopped when no longer needed. Palliative care can transition with you, no matter where you are on your health journey. Palliative care can be provided alongside curative treatments, while hospice care is typically offered when curative treatments have been discontinued. 

Hospice care focuses on comfort and quality of life for terminally ill patients and their families, emphasizing pain relief and symptom management instead of life-prolonging treatments. The intention is to make the end of life as comfortable and yes, even peaceful as possible for the patient and the people who love them.

I think it is important for you to know that palliative care is available to anyone with a serious illness, regardless of their prognosis, while hospice care requires a doctor's certification of a life expectancy of six months or less to live.

Palliative care can be provided in various settings, including hospitals, clinics, and homes, while hospice care is primarily provided in the patient's home or in a hospice facility.

Hospice care is generally well-covered by insurance, including Medicare, Medicaid, and many private plans. Palliative care can be covered by insurance as well, but the specifics vary. I encourage you to speak to your insurance provider to find out what is covered under your particular plan.

A quote I often share: "All hospice care involves palliative care, but not all palliative care takes place in hospice." (author unknown)

Palliative sedation, which I prefer to refer to as Proportionate Palliative Sedation (PPS), involves administering medication to lower a patient's consciousness just enough to alleviate unbearable suffering, ensuring their comfort while maintaining their capacity to interact with their surroundings as much as possible. This is a last-resort intervention in palliative care, mainly used for patients with terminal illnesses who are experiencing severe and untreatable symptoms.

Since I am currently employed as a pediatric palliative care nurse, I would like to provide you with a brief overview of this field. Pediatric palliative care involves specialized medical care for children facing life-threatening or life-limiting conditions, with an emphasis on enhancing their quality of life and addressing both their physical and emotional needs.

We cannot change the diagnosis or the outcome, however we can make sure that you or someone you love has a team that will support you through this process whether it takes years, months, weeks, or days, making sure to guide all involved until that last breath is taken. Both palliative care and hospice care are available for anyone who is navigating decline from age or illness. Neither are a diagnosis, they both align with the plan of care for the diagnosis.

Perhaps if people realized how accessible this information and education is, they would consider palliative care sooner and have a more graceful transition to hospice if/when it is appropriate. Increasing the education about this could end up being the difference between a distressing or peaceful death, ensuring that each person receives good care, valuable resources, and support earlier on.

xo

Gabby

I am grateful to the two doctors who read, reviewed, and provided feedback on my writing, as well as to Google for the information I researched to compile this blog. Their assistance was invaluable in helping me accurately explain the differences between hospice and palliative care.