What is the difference between palliative care and hospice?

The home visiting physician discusses the health of the elderly hospice patient with him and his wife.Palliative care and hospice can provide comfort to the seriously ill and patients who have received a prognosis of imminent death. Any type of care is intended to improve the quality of life among the patients who receive it. Many people use the terms hospice care and palliative care interchangeably, but there are important distinctions. Here are the differences between palliative care and hospice.

Hospice care

Hospice care is comfort care usually available to patients who have a terminal illness diagnosis and a prognosis of six months or less to live. His doctor must declare to the hospice care that the patient will not recover from his illness and will die if the illness follows its course as expected.

A patient may, for example, decide to forgo further medical treatment for an inoperable brain tumor. In seeking hospice care, the individual opts against enduring certain medical procedures that would leave them unable to enjoy precious quality time with their loved ones.

Palliative care

Palliative care is like hospice care in that it is intended to provide comfort to seriously ill patients. However, palliative care treats patients who are still receiving medical intervention, unlike hospice care. Patients can request palliative care at any stage of their illness, from diagnosis to curative treatment, not just at the end of life. For example, someone living with Stage 1 cancer may seek palliative care, even if undergoing treatments such as chemotherapy.

This type of care may include any or all of the following:

  • Medicines to relieve pain and other drugs that can help relieve symptoms such as nausea, fatigue, anxiety and insomnia.
  • Support in talking about and understanding options and goals for medical care
  • Teaching self-care techniques, such as breathing exercises or meditation
  • Nutritional advice
  • Emotional and spiritual support for the patient and their family members
  • Help discuss and weigh difficult decisions about end-of-life treatment, if necessary
  • Assistance in connection with health care providers and appropriate specialists

Who is Eligible for Palliative Care vs. Hospice Care?

Hospice and palliative care target different types of patients. The eligibility requirements for each type of care are different from each other.

Hospice care requires two doctors who treated the patient to certify that the patient has less than six months to live and that his condition is unlikely to improve with further medical intervention. Primary care physicians may be among the two doctors who provide an opinion, but this is not necessary.

Palliative care begins at the option of the patient and his doctor at any stage of the disease. Patients receiving palliative care do not need to be close to the end of their lives. Patients who no longer benefit from curative treatments or who have limited ability to care for themselves may choose to pursue palliative care.

Who will test the care you receive?

Hospice care

Patients in hospice care will receive comfort care from doctors and nurses who specialize in the field.

Palliative care

Patients in palliative care will receive care from doctors and nurses along with various palliative care experts, including therapists, counselors, social workers and nutritionists.

Where do you get care?

Hospice care

A patient can receive hospice care at home, in an assisted living facility, a nursing home, or in the hospital.

Palliative care

Palliative care may be limited to patients admitted to hospital because palliative care teams are usually based outside these facilities. This may vary depending on your state, however. According to a study, states with so-called palliative care laws could help ensure that patients receive this care in the place of their choice, even at home.

Paying for care

Determining who pays for hospice or palliative care is an important part of long-term care planning. Medicaid, Medicare, or private insurance may pay for hospice care and palliative care to some extent.

Payment for Hospice Care Through Medicare or Medicaid

A senior’s Medicaid benefits will pay for hospice care without requiring a co-payment. Medicaid covers all services that are deemed appropriate to keep the patient comfortable. Medicaid will cover prescriptions, social services, medical equipment, day and night nursing and medical care, and grief counseling for families after the patient dies.

Hospice care through Medicare, meanwhile, covers services that provide a better quality of life for the patient. The individual must have Part A of Medicare and have two doctors, as mentioned above, certify that their life expectancy is six months or less. Read more about how to qualify for the Medicare hospice benefit.

Payment of palliative care

Patients on Medicaid may have their costs covered, but may expect to pay a co-payment for doctor visits or appointments with advanced practice nurses. Medicaid will pay for palliative care as long as the patient needs and responds to palliative care. Medicaid, and how much and how much it will cover palliative care, is regulated by state law.

Medicare coverage for this type of care can depend on a variety of factors. Different parts of Medicare may cover some services called “comfort care.” Contact your doctor to determine the extent of your coverage.

Many patients who need palliative care will pay for it through private insurance. Review your insurance policy and speak to a representative of your insurance company if you have questions about your coverage, as plans vary widely.

To find hospice and palliative care services in your area, visit the National Hospice and Palliative Care Organization website. For more guidance on advance planning, consider consulting with a qualified elder law or estate planning attorney near you.

Creation date: 11/20/2023

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