Understanding the Difference Between Palliative Care and Hospice Care

When you or a loved one are coping with the diagnosis of a serious illness, choosing the best type of health care can feel confusing and overwhelming. By understanding options and planning for when an illness progresses, you can actively prioritize health goals that matter most and maximize quality of life.

While both palliative and hospice care aim to improve the quality of life for people with serious illnesses, they aren’t exactly the same. One key difference between palliative care and hospice care is that you do not need a six-month prognosis to receive palliative care — unlike hospice care, you can receive it anywhere along the disease trajectory. You can aggressively seek treatment for your illness alongside palliative care but must stop all curative treatments before beginning hospice care.

But that’s not all you should know. Let’s dig deeper to understand the similarities and differences between these two types of care. 

Palliative Care  

What is palliative care? 

Palliative care is a medical specialty that focuses on helping people with serious illnesses get relief from the symptoms, pain, and side effects they experience. Palliative care providers can help you focus on treating the symptoms that affect your quality of life, even as you receive treatment for your underlying illness from other health care providers.  

Palliative care can assist you in navigating the pros and cons of medical interventions such as ongoing hospitalizations or procedures related to your serious illness. Palliative care providers can also support you in your decision-making processes, including helping you with advance care planning — thinking, discussing, and recording your health care wishes to ensure they’re known, understood, and respected if and when you become unable to advocate for yourself.

Palliative care is appropriate for anyone with serious illnesses, including:

• Alzheimer’s and dementia
• Parkinson’s disease
• Cancer
• Heart failure
• Liver disease
• Lung disease
• Kidney disease
• Stroke
• And more

Palliative care is appropriate for every stage of a serious illness, from diagnosis until the end of your life. You can seek out curative treatments while you receive palliative care.

Does Medicare cover palliative care? 

Generally speaking, palliative care is covered under Medicare Part B.

What are the benefits?

Palliative care can help you reduce the negative impact of your disease on the quality of your life. That’s a research-backed fact — in a systematic review of 43 research trials, researchers found that palliative care is associated with improved quality of life and reduced symptom burden.

Addressing your quality of life means more than just tackling physical symptoms. In addition to pain relief and practical treatment guidance, you have the option to receive emotional and spiritual support from your care team. You can work with palliative care providers to define the quality-of-life goals that matter to you and work toward them together.  

Palliative care can also improve the quality of life for caregivers by allowing them to share the duties of care with a qualified health care team. Palliative care specialists can help educate caregivers on how they can expect illnesses to progress and equip them with practical tools to help assist their loved ones.  

Where will you receive care? 

Where you’ll receive care depends on your chosen health provider and the services they offer. Some of the possibilities include receiving care at home as part of an outpatient program, during a short-term hospital stay, or within a long-term or chronic-care setting.

Hebrew SeniorLife offers several palliative care programs:

• We have a community-based palliative care program to provide these services in the comfort of your home to anyone within our Greater Boston service area, including residents of Hebrew SeniorLife’s senior living communities.
• You will have access to palliative care if you receive inpatient skilled nursing care at either one of our post-acute rehabilitative care units at Hebrew Rehabilitation Center in Roslindale or Dedham.
• Hebrew Rehabilitation Center also offers palliative care as part of long-term chronic care, including for patients at the end of life. 
• At the Deanna and Sidney Wolk Center for Memory Health, we offer outpatient palliative care so people with dementia and their families can better understand and manage how dementia affects their lives. 

Hospice Care 

What is hospice care? 

Like palliative care, hospice care focuses on quality of life and symptom management for people with serious illnesses. However, you only qualify for hospice care if you have a life expectancy of six months or less and are no longer seeking curative treatment.   

What are the benefits? 

I’ve repeatedly seen the wonderful benefits of hospice care in my decade of work as a hospice nurse. Hospice gives you access to an interdisciplinary team of health care providers, including a registered nurse case manager, social workers, physicians, spiritual counselors or chaplains, and volunteers. Hebrew SeniorLife also offers complementary therapies such as reiki, pet therapy, music therapy, and massage, which aren’t available at every hospice program. You can read more about who makes up a hospice care team in this blog post.

Like palliative care, hospice improves quality of life. Before entering hospice, some people with serious illnesses struggle to manage their symptoms and experience frequent hospitalizations as a result. Frequent hospitalizations aren’t good for quality of life and can sometimes cause significant health setbacks. Once you decide that you’d like to receive treatment at home, you can avoid those visits by bringing a lot of care and support into your home. The focus shifts to quality of life instead of quantity of life. Some studies have actually linked hospice care to living longer!

I have witnessed situations where having a chaplain or spiritual advisor visit a patient in distress helped them to become more comfortable and relieve their symptoms — by just having an interdisciplinary team around you to meet all of your needs, important aspects of health like addressing spiritual or psychosocial crises don’t go overlooked.

Hospice is also beneficial to family members. In one study where researchers interviewed spouses and adult child caregivers after the death of loved ones with dementia, 67% whose loved ones were enrolled in hospice said their own sadness and anxiety were managed, compared to 46% of non-hospice enrollees. At Hebrew SeniorLife, bereavement support begins before death to guide family members anticipating loss and provides grief support for a minimum of 13 months after that loved one has passed on. 

Does Medicare cover hospice? 

Hospice is fully covered by Medicare under Medicare Part A, as well as most private insurance plans. While you need to have a life expectancy of six months or less to qualify for hospice care, that doesn’t mean the benefit has a six-month maximum. The hospice team will continue to evaluate your prognosis, and some people continue to receive hospice care longer.  

Where will you receive care? 

While the service does not generally provide 24/7 care unless crisis-level criteria are met, you’ll be able to access care 24/7. A majority of hospice programs offer 24-hour phone coverage to patients who don’t need continuous care. If you’re receiving hospice at Hebrew SeniorLife, for example, you can take advantage of our 24-hour nursing telephone coverage and call someone for help if a symptom is worrying you at 2 a.m., or a nurse can also visit. This can help prevent unnecessary hospitalizations that make it harder for you to stay comfortable.

Medicare defines four levels of hospice care:

• Routine home care – You receive care at home, and your symptoms are stable. Routine home care is the most common type of hospice care. 
• General inpatient care – You receive crisis-level care in an inpatient setting for short-term management of out-of-control symptoms. The goal is to get you back to routine home care. 
• Continuous home care – You receive crisis-level care at home for short-term management of out-of-control symptoms. The goal is to get you back to routine home care. 
• Respite care – You receive care temporarily in a medical facility to give your caregiver some time off (up to five days). Respite care tends to the caregiver’s needs and helps prevent burnout. 

No matter where you’re receiving hospice, each level of care is available.

Palliative Care vs. Hospice Care

The following table breaks down some of the key differences between palliative care and hospice care:

Hebrew SeniorLife Difference

Whether it’s from our hospice team or palliative care team, patients at Hebrew SeniorLife can expect to receive high-quality care. Hebrew SeniorLife received the Hospice CAHPS Award of Distinction, which is only awarded to hospice organizations that have demonstrated superior performance in patient satisfaction.

One of our key differentiators is our deep familiarity with Jewish traditions, which makes us well-positioned to offer compassionate Jewish hospice care. However, we provide spiritual care and end-of-life support for people from all faiths, backgrounds, and religions, with all of our chaplains being either board-certified in interfaith chaplaincy or studying to become so.

The care we provide at Hebrew SeniorLife is guided by each patient’s personal preferences and care goals. We provide hospice and palliative care services in the Greater Boston area that support the patient’s physical, emotional, and spiritual needs while supporting caregivers and families. Anyone can make a referral to our hospice or palliative care programs — a patient, a family member, a physician, or a nurse. Contact us today to learn more.