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

While receiving treatment for ovarian cancer, Erin felt anxious and worried about her treatment plan and the decisions she needed to make.

“I didn’t want to spend a lot of time in the hospital and with my diagnosis, I didn’t know what the future would hold,” Erin said. Because she was receiving palliative care, which focuses on relieving symptoms and stress associated with serious illnesses and chronic conditions, she had support for all aspects of her life.

When managing a serious illness, “people can experience pain and stress in various aspects of their lives, including physical discomfort, and emotional, social, and spiritual concerns,” said Dr. William Logan, national medical director for Carelon Health palliative care.
 

Defining Hospice and Palliative Care

Palliative care is often confused with hospice care. People who choose palliative care typically have a serious medical condition such as cancer, chronic heart failure, chronic obstructive pulmonary disease (COPD), dementia, and Parkinson’s disease. They may choose palliative care at any point during their illness to relieve pain and anxiety of any kind – physical, emotional, or spiritual. Palliative care works along with other treatments specifically aimed to treat or cure their illness and focuses on managing symptoms like pain, nausea, shortness of breath, and fatigue.

Hospice care offers comfort and compassion to people nearing the end of life; typically, they have chosen to not pursue further treatment. In hospice care, the focus shifts to helping a person remain comfortable by managing pain and offering emotional and spiritual support. People may choose hospice care to help a loved one spend their end-of-life time living comfortably outside a hospital setting. Hospice care focuses on giving each patient and family the best possible quality of life.
 

What Is Palliative Care?  

Think of the palliative care team as a person’s personal health provider who takes a holistic view of their situation and ensures all aspects of their healthcare work together. Logan said this approach improves a person’s overall well-being by relieving pain and discomfort, without focusing solely on disease-focused medical treatments.

“We can develop personalized treatment plans to alleviate pain and discomfort, whether it involves prescribing medications or offering counseling or spiritual support,” Logan said. “Our physicians and advanced practice care providers listen carefully to understand priorities and what makes each person’s life meaningful. The physician-led team tailors the care plan for each individual to help achieve those goals.”

Care teams led by palliative care specialist-physicians include nurse practitioners, social workers, and specialized nurses. These teams visit individuals in their home at least once a month, or more frequently as needed. This allows more time, outside of the doctor’s office, for individuals to discuss their conditions, concerns, and their wishes for care. The care team conducts full medication reviews to ensure medicines prescribed by different care providers do not conflict, and they help each person follow their treatment plans. Care teams also communicate and coordinate with the individual’s primary care provider and other medical specialists.

This comprehensive support for each person reduces frequent trips to emergency departments and hospital stays. Erin was able to stay home—just as she had hoped—while receiving care via phone and video at any time.
 

Easing the Stress for Caregivers and Families

Palliative care also helps caregivers look out for their own health and well-being. It provides counseling to help them manage stress and offers information to better understand their loved one’s goals and illness. The care team can also connect the family with community resources, such as meal delivery, respite resources, or transportation. This whole-health approach supports caregivers, like Erin’s husband Dale, to take better care of themselves alongside the person for whom they are caring.

“What I appreciated most was when I realized palliative care was also for me,” Dale said. “I felt included, like I was part of the team.”

Ensuring Healthcare Wishes are Understood and Respected

As part of palliative care, social workers assist with discussing advance directives, which are legal documents outlining a person’s medical care wishes. They are trained to host family meetings that guide patients and families through their choices and help ensure everyone involved in the person’s care understands and respects those goals and wishes. These are important steps that help relieve the stress that comes from living with a serious illness.

Palliative care can also help manage the transition to hospice if that becomes appropriate. Palliative care provides expanded support and treatment to help manage a person’s condition before they may need hospice care. This extra care can sometimes delay or even prevent the need for long-term hospice care.

Erin credits palliative care with her healing and peace of mind, especially with support from her palliative care nurse practitioner.

“I would encourage everyone to take advantage of opportunities that are there for support,” Erin said.