Palliative care vs hospice care are two types of care that aim to improve the quality of life of people with serious or life-limiting illnesses. However, they are not the same and they have different goals, eligibility criteria, and coverage.
In this article we will be explaining the difference between palliative care and hospice care, why palliative care is not always the best option, and when someone should be offered palliative care or hospice care.
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What is Palliative Care?
Palliative care is a type of care that focuses on relieving the symptoms and stress of a serious illness, regardless of the diagnosis or prognosis. Palliative care can be provided at any stage of the illness, along with curative or life-prolonging treatments. Palliative care is provided by a team of doctors, nurses, social workers, chaplains, and other specialists who work together with the patient’s primary care provider and specialists. Palliative care can be offered in various settings, such as hospitals, clinics, nursing homes, or at home.
The main goal of palliative care is to improve the quality of life of the patient and the family by addressing their physical, emotional, social, and spiritual needs. Palliative care can help with pain and symptom management, advance care planning, communication and coordination of care, emotional and spiritual support, and practical assistance.
What is Hospice Care?
Hospice care is a type of care that provides comfort and support to patients and families who are facing a terminal illness and a life expectancy of six months or less. Hospice care is based on the philosophy that death is a natural part of life and that patients should be allowed to die with dignity and peace. Hospice care does not seek to cure the illness or prolong life, but rather to make the most of the remaining time.
Hospice care is provided by a team of hospice professionals and volunteers who work together with the patient’s primary care provider and specialists. Hospice care can be offered in various settings, such as hospice facilities, hospitals, nursing homes, or at home.
The main goal of hospice care is to provide comfort and support to the patient and the family by addressing their physical, emotional, social, and spiritual needs. Hospice care can help with pain and symptom management, end-of-life care, bereavement support, and grief counseling.
Difference Between Palliative Care and Hospice Care
The following chart summarizes some of the key differences between palliative care and hospice care:
| Palliative Care | Hospice Care |
| Can be provided at any stage of the illness | Can only be provided when the patient has a terminal diagnosis and a life expectancy of six months or less |
| Can be combined with curative or life-prolonging treatments | Cannot be combined with curative or life-prolonging treatments |
| Does not require a physician’s referral or certification | Requires a physician’s referral and certification |
| May or may not be covered by Medicare, Medicaid, or private insurance | Is fully covered by Medicare, Medicaid, and most private insurance |
| Does not have a limit on the duration or frequency of care | Has a limit on the duration and frequency of care, which can be renewed if the patient’s condition worsens |
Why Palliative Care is Not Always the Best Option
Palliative care can be very beneficial for patients and families who are coping with a serious or life-limiting illness. However, palliative care is not always the best option for everyone. Here are some reasons why palliative care may not be suitable or preferable for some patients:
- Palliative care may not be available or accessible in some areas or settings, especially in rural or remote areas, or in low-resource countries.
- Palliative care may not be compatible with some patients’ cultural, religious, or personal beliefs or preferences, especially if they value aggressive or heroic treatments, or if they have a strong hope for a cure or a miracle.
- Palliative care may not be affordable or covered by some patients’ insurance plans, especially if they have high deductibles, co-pays, or out-of-pocket expenses.
- Palliative care may not be effective or sufficient for some patients’ symptoms or needs, especially if they have complex or refractory symptoms, or if they require intensive or specialized care.
- Palliative care may not be acceptable or supported by some patients’ family members or caregivers, especially if they have unrealistic expectations, conflicting opinions, or poor communication.
When Should Someone be Offered Palliative Care or Hospice Care?
There is no definitive answer to when someone should be offered palliative care or hospice care, as it depends on many factors, such as the patient’s diagnosis, prognosis, goals, values, preferences, and needs. However, some general guidelines are:
- Palliative care should be offered as early as possible in the course of a serious or life-limiting illness, ideally at the time of diagnosis or soon after.
- Hospice care should be offered when the patient has a terminal diagnosis and a life expectancy of six months or less, and when the patient and the family agree to forgo curative or life-prolonging treatments.
- Palliative care and hospice care should be offered in a sensitive and respectful manner, with clear and honest information, and with the patient’s and the family’s consent and involvement.
Conclusion
Palliative care and hospice care are two types of care that aim to improve the quality of life of people with serious or life-limiting illnesses. However, they are not the same and they have different goals, eligibility criteria, and coverage.
Palliative care can be provided at any stage of the illness, along with curative or life-prolonging treatments, while hospice care can only be provided when the patient has a terminal diagnosis and a life expectancy of six months or less, and when the patient and the family agree to forego curative or life-prolonging treatments.
Palliative care is not always the best option for everyone, as it may not be available, accessible, compatible, affordable, effective, or acceptable for some patients. Palliative care and hospice care should be offered in a timely and appropriate manner, with respect and compassion, and with the patient’s and the family’s consent and involvement.
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