What Is the Difference Between Palliative Care and Hospice?

According to the Center to Advance Palliative Care, palliative care is specialized medical care that aims to relieve symptoms and emotional distress in patients and families living with a serious illness. The care is typically delivered by a palliative care team that includes a physician, a nurse (or several nurses), a social worker, a chaplain and other professionals, such as physical and occupational therapists, as needed. Some teams also include a registered dietician, a psychologist or psychiatrist, and a team of integrative therapists, such as massage therapists, aromatherapists and acupuncturists. Translator services are typically available for non-English speaking patients as well. 

Unlike hospice care, which is generally reserved for patients who have fewer than 6 months to live, palliative care is appropriate for anyone living with a serious illness regardless of their prognosis. It can be started at the time of diagnosis and continued alongside curative care. 

Palliative care revolves around the patient and their family — the focus is on identifying and alleviating sources of discomfort and stress throughout the course of the disease. This requires ongoing assessment and regular follow-ups because these sources are not stagnant. What the patient and their loved ones need at the time of the diagnosis may be very different from their needs as the patient approaches the end of life. Although the scope of care they provide is very broad, issues the team can help address include the following:

• Physical issues, such as fatigue, pain, shortness of breath, nausea and vomiting, loss of appetite and difficulty sleeping. Doctors can prescribe medications to address many of these symptoms, while other healthcare professionals can add more layers of support, such as massage, nutrition counseling, positioning and breathing techniques. 

• Emotional issues, such as fear, anxiety, depression and despair. Some of these issues can be addressed with medication, and mental health professionals can provide counseling, referrals to support groups and other kinds of support as well.

• Practical concerns, such as financial worries, insurance issues, child care, housing or transportation needs. As a rule, the palliative care social worker will help the family navigate these systems, find appropriate resources and request aid. 

• Spiritual needs, which become more important to many people who are facing a serious illness. Chaplaincy services offer spiritual counseling or simply provide a safe place for the patient and their family to discuss their values and goals. 

If you believe palliative care can help you or your family cope with your illness, speak with your doctor about a referral to a palliative care team. Most medical centers in the U.S. offer a palliative care service, although many only provide care to patients who are hospitalized. With that being said, more and more centers are developing outpatient palliative care teams for  patients with serious illnesses such as cancer, heart disease or COPD. Ask your primary care doctor what’s available in your area, or, if you’re hospitalized, ask to meet with the nurse case manager to explore what options are available to you. 

Sources
“What is Palliative Care?” The Center to Advance Palliative Care.  https://getpalliativecare.org/whatis/