Palliative vs. hospice care: What’s the difference?

While often mentioned in tandem, it’s helpful to know the difference between hospice and palliative care when you or a family member has a serious illness. Both types of care aim to enhance comfort and quality of life and support patients with chronic or life-threatening conditions.

Understanding care options empowers you to make informed decisions. It also helps your loved ones to make decisions, as needed, and get support.

"Both hospice and palliative care prioritize managing a person's physical and emotional pain associated with an illness, yet there are key differences," says Glen Digwood, DO, the division chief of palliative care for Geisinger.

What is palliative care?

Palliative care is dedicated to enhancing the quality of life for people of any age or stage of illness.

"This care approach assists patients in effectively managing their symptoms while pursuing aggressive medical treatments," says Dr. Digwood. “Everyone deserves comprehensive symptom management, whether or not their illness can be cured.”

Palliative care supports children or adults with conditions such as:

• Cancer
• Congestive heart failure
• Chronic obstructive pulmonary disease (COPD)
• Dementia
• Kidney disease
• Parkinson’s disease
• Stroke

Your palliative care team can also address psychological, social and spiritual needs. Their goal: to deliver maximum physical and emotional relief for those with serious illnesses.

When you receive palliative care, you can still receive treatments designed to cure your illness. In fact, it can enhance your options for cures.

Another difference from hospice care is that a palliative care team collaborates with your existing healthcare providers rather than replacing them. This partnership means you’ll have coordinated, comprehensive care.

Though hospice and palliative care are distinct services, they share common goals and can often work in tandem. In fact, hospice care can be seen as a specialized form of palliative care. You can begin receiving palliative care immediately after diagnosis.

What is hospice care?

People typically qualify for hospice when their illness is deemed life-limiting, usually with a prognosis of 6 months or less. Hospice care emphasizes maximizing quality of life during this limited time frame, with a strong focus on pain control and comfort.

A hospice team can care for you in various settings, including your home, a hospital, a skilled nursing facility or in a hospice facility dedicated to end-of-life care. Trained professionals provide care after you and your family opt for this supportive approach.

Many find comfort in receiving hospice care at home and prefer to have care there. “Over 95% of hospice care is provided in patients' homes, where care teams visit them,” says Dr. Digwood.

The hospice team is available around the clock, conducting regular visits to assess patient needs. This multidisciplinary team typically includes nurses, home health aides, social workers, chaplains, therapists and a physician. They answer questions and support family members as well as care for the patient.

If you live longer than the expected 6 months, you can extend hospice care. And if your condition improves or you want to try a medical treatment that could cure you, you can shift from hospice to palliative care. 

When do you transition from palliative care to hospice care?

"As a person's condition evolves or when treatments no longer enhance their quality of life, the supportive services may transition to include hospice care," says Dr. Digwood.

With a strong emphasis on pain control and quality of life, hospice care focuses your health team on making the time you have as comfortable and joyful as it can be.  

An ill person may shift from palliative to hospice care if:

• Treatments are no longer working
• Treatments are causing intolerable symptoms, like severe vomiting, deep fatigue or painful sores that don’t heal
• A doctor believes the ill person is likely to die within 6 months

Signs it’s time to transition to hospice include when the ill person:

• Doesn't want to use aggressive interventions
• Increasingly needs hospital or emergency room visits to care for symptoms, side effects or pain
• Is losing weight for no reason and has no appetite
• Has recurrent infections
• Sleeps most of the time
• Seems confused, restless or unable to communicate

If you're navigating a serious health diagnosis, consider discussing care service options with your doctor.

"Talk to your healthcare providers and your family members or support system about palliative care, hospice care and any preferences you have. Give your healthcare providers and family members clear directions about your wishes, preferably an advanced directive in writing," says Dr. Digwood. "This will help them respect your wishes and ease their minds as they make challenging end-of-life choices."

Next steps: 

Find a hospice and palliative care provider
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