With Thanksgiving behind us, we’ve been reminded of the many things for which we’re grateful.
For me, that includes hospice care and palliative care—since both have played such a significant role in my life.
Since November was also National Hospice and Palliative Care Awareness Month (aka National Hospice Month), National Home Care and Hospice Month, and National Family Caregiver Month, it’s a great time to talk about the differences between hospice care and palliative care.
This information is important for individuals in need of care and the family caregivers who are caring for them.
Dear to my heart
I’m both a former hospice professional and a former family caregiver, so raising awareness about the benefits of these offerings is a passion of mine—which is why I continue to write and share about these topics in a variety of ways.
When my mom’s health started a steep decline toward the end of her life, hospice wasn’t yet an option for a variety of reasons. Though I was able to provide most of her care, she still needed to see a doctor on a regular basis.
With her mobility a growing challenge, we faced limited options since she could no longer ride in the car. This is a common scenario for those living in the community with serious illness, where gaps in care options can be a big challenge.
Just as I was starting to wring my hands, a friend told me about a new community-based palliative care practice that had opened in our community.
I contacted them and the doctor came out within the next few days to admit Mom and care for her needs. This service continued until she was ready for hospice in the last three weeks of her life, at which time a smooth transition between the two services took place.
Hospice care and palliative care lingo
When we talk about hospice and palliative care, the two terms often exist within the same breath. But they’re not the same.
Palliative care is often referred to as “comfort care” and it’s an essential component of the care that patients receive within the auspices of a hospice program.
However, this service can also stand alone—separate from hospice—providing a critical bridge across the gap of care that exists for many with serious illness, like Mom.
Although palliative care programs have existed within hospital settings for some time, community-based programs like the one we accessed are fairly new to the scene. Fortunately, they’re becoming increasingly available for those who need them.
2 ways hospice care and palliative care are different
Here are two ways hospice care and palliative care are different:
- Timeframe: Hospice care is appropriate for those with a life expectancy of six months or less, but palliative care is appropriate for anyone with serious illness.
- Treatment focus: Hospice care focuses strictly on comfort care, but palliative care allows an individual to continue to pursue curative care while receiving comfort care.
- A primary focus is the relief of pain and other symptoms to optimize quality of life.
- Care is provided through an interdisciplinary approach to address physical, spiritual, and psychosocial needs.
- Care is provided by practitioners skilled in a holistic approach to care that focuses on identifying patient and family goals to make sure the type of care provided is that which the patient wants.
Hospice care is paid for through the Hospice Medicare/Medicaid Benefit or traditional insurance, but palliative care is typically covered through traditional Medicare/Medicaid or insurance.
The National Hospice and Palliative Care Organization (NHPCO) provides a concise comparison of hospice and palliative care in their handout, “Pallative Care or Hospice? The right service at the right time for seriously ill individuals.”
Is palliative care right for you or your loved one?
If serious illness is involved, the answer is often a resounding “yes.” This is especially true if pain and symptom management is an issue—since palliative care professionals are experts in this area.
They’re also experts in helping patients and families look at the “big picture” and plan accordingly, instead of getting caught in the siloes of care that often occur when numerous specialties are involved. When this happens, patients are too-often placed on a treatment treadmill that doesn’t align with their goals.
Through its consumer site: GetPalliativeCare.org, the Center to Advance Palliative Care (CAPC) offers a five-question assessment to help you determine if palliative care is right for your situation. You can access the assessment here:
Finding a palliative care program in your area
Many hospitals—especially in urban areas—have a palliative care team. So if a hospitalization is involved and you would like to be connected with these experts, ask for a consult.
CAPC recently published a summary of America’s Care of Serious Illness: 2019 State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals, which you can access in its post, “Did Your State Make the Grade?“
However, finding a community-based palliative care provider may prove a little more difficult, since this model of care is still fairly new. I’ve had several friends who I tried to help access services in their areas, only to find they were not yet available.
Although Mom received her care from an independent program, community-based palliative care is often provided through a hospice program, so contacting the hospice(s) in your area to see whether this option is available can be a great place to start. In addition, CAPC offers a searchable directory of palliative care providers.
It’s often best to talk to your healthcare provider first to discuss your condition, concerns, and available options—which may include palliative care. Your healthcare provider can then help you find a palliative care program in your area if one is available, and make the referral you’ll likely need.
For more information, here are a few additional articles I’ve written on this topic, as well as links to organizations that can help:
- Community-Based Palliative Care: California Leading the Way
- Living with a disability: Why the right support can make all the difference
- A cat. A movie. And peppermint patties. Sometimes there are alternatives to hospitalization.
- Mobile Palliative Medicine: In Our Home and on the Frontier
Organizations that can help:
- CAPC’s Get Palliative Care (For consumers)
- National Hospice and Palliative Care Organization’s (NHPCO) CaringInfo (For consumers)
- California State University’s Shiley Institute for Palliative Care (The CSU Shiley Institute for Palliative Care provides training and other resources for clinicians. I’m an author/co-author for a number of courses there.)