If the hospice philosophy of offering comforting care and alleviating pain also underlies palliative care, what’s the difference?
It boils down mostly to who’s eligible for each, when they get that care and where it takes place. But the lines blur.
“Hospice is specialized care for patients who have been given a terminal diagnosis with a prognosis of six months or less,” according to the National Hospice and Palliative Care Organization, the largest non-profit for the two programs and professionals in America. NHPCO points out that palliative care is specialized medical care for people with serious illnesses, whatever the diagnosis. It provides support for patients and their families and “is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.”
In other words, hospice patients are almost always terminal. To qualify for Medicare benefits, they are supposed to live no longer than half a year. With palliative care, patients only have to be seriously sick with pain or other potentially debilitating symptoms.
People in hospice aren’t still trying to be cured by medical treatment. Those in palliative care often are, with aggressive therapies like chemo, radiation and surgery.
Palliative care is often — at least at first — carried out in a hospital by an interdisciplinary team of physicians, medical specialists like oncologists or neurologists plus pharmacists, social workers, mental health workers and clergy. The team’s focus is on improving quality of life — physically, mentally and spiritually — for patients as well as their families.
Hospice care, of course, is also about easing suffering. It, too, focuses on patients’ quality of life and supporting their families — but it’s through the dying process and bereavement that follows. And although often overseen by a team of hospice professionals, hospice usually takes place in the patient’s home. The key on-the-scene players are a visiting hospice nurse and the family caregiver.