What is the difference between palliative and hospice care?

A home visiting physician discusses with him and his wife the medical condition of an elderly hospice patient.Palliative care and hospice care can provide comfort to critically ill patients and patients who have received a prognosis of imminent death. Each type of care is designed to improve the quality of life of those patients. Many people use the terms hospice care and palliative care interchangeably, but there are important differences. Here are the differences between palliative and hospice care.

Hospice care

Hospice care is comfort care generally available to patients diagnosed with a terminal illness and expected to live six months or less. Their doctor must report to hospice care that the patient will not recover from their illness and will die if the illness progresses as expected.

A patient may, for example, decide to forgo further medical treatments for an inoperable brain tumor. When seeking hospice care, an individual tends to endure certain medical procedures that will prevent them from enjoying precious quality time with loved ones.

Palliative care

Palliative care is similar to hospice care in that it is designed to provide comfort to terminally 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, and not just at the end of life. For example, someone living with stage 1 cancer may seek palliative care even if they are undergoing treatment such as chemotherapy.

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

  • Pain medications and other medications that can help relieve symptoms such as nausea, fatigue, anxiety, and insomnia
  • Support to talk about and understand your own medical care options and goals
  • Learning self-care techniques such as breathing exercises or meditation
  • Nutritional counseling
  • Emotional and spiritual support for the patient as well as their family members
  • Help discuss and weigh difficult decisions about end-of-life care when needed
  • Assistance in contacting appropriate health care providers and professionals

Who is eligible for palliative care vs. hospice care?

Hospice care and palliative care are aimed at different types of patients. The eligibility requirements for each type of care vary from one to the other.

Hospice care requires both treating physicians to certify that the patient has less than six months to live and that their condition is unlikely to improve with further medical intervention. Primary care physicians may be among the two physicians who provide an opinion, but are not required to do so.

Palliative care begins with the choice of the patient and their physician at any stage of the disease. Patients receiving palliative care do not need to approach the end of their lives. Patients who no longer benefit from curative treatments or have limited ability to care for themselves may choose palliative care.

Who will provide the care I receive?

Hospice care

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

Palliative care

Palliative care patients will receive care from doctors and nurses, as well as a variety of palliative care experts, including therapists, counselors, social workers, and nutritionists.

Where can I get care?

Hospice care

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

Palliative care

Palliative care may be limited to patients admitted to hospital, as palliative care teams usually work from these facilities. However, this may vary depending on your state. According to one study, states with so-called palliative care laws can help ensure that patients receive this care in the setting of their choice, including at home.

Payment for care

Deciding who pays for hospice or palliative care is an important part of long-term care planning. Medicaid, Medicare, or private insurance may pay some of the cost of both hospice and palliative care.

Payment for hospice care through Medicare or Medicaid

Senior Medicaid benefits will pay for hospice care without requiring a co-pay. Medicaid covers all services 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 a patient dies.

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

Payment for palliative care

Medicaid patients may have their own costs covered, but they can expect to pay co-pays for doctor visits or appointments with primary care nurses. Medicaid will pay for palliative care as long as the patient needs and responds to palliative care. Medicaid, and how much and how long it will cover palliative care, is governed by state law.

Medicare coverage for this type of care can depend on a variety of factors. Different parts of Medicare may cover some so-called “convenience care” services. Contact your healthcare provider to determine your coverage amount.

Many patients who need palliative care will pay for it through private insurance. Review your insurance policy and talk to your insurance company representative 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 Association website. For further guidance on advance planning, consult with a qualified elder law or estate planning attorney near you.

Date of creation: 20.11.2023

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