Palliative Vs Hospice: Which Type Of Care Is Right For Your Loved One?
Both palliative care and hospice care prioritize the recipient’s overall quality of life, values, and goals. Understanding the difference between the two is essential in making the most appropriate choice for your loved one’s care.
We’ll discuss factors to consider when deciding between the two care options, including:
- The timing of the care
- The goals of the care recipient
- The progression of the condition
- The degree of support needed
Check out the Trualta library for more resources on palliative care, hospice, and other topics related to caregiving. Use this link to find out if you have free access.
The Timing & Eligibility Of Care
Palliative Care
- Palliative care services, also known as “supportive care”, can be initiated at any point during the recipient’s care. This includes soon after diagnosis and when their end of life is not imminent.
- Palliative care providers can work with the care recipient at any point after diagnosis to help alleviate symptoms associated with a chronic diagnosis.
- Examples of this include: managing a patient’s persistent nausea from the side effects of chemotherapy or assisting a family trying to address insomnia with a patient with Alzheimer’s disease.
Hospice
- Individuals become eligible for hospice, or “comfort care”, when they have a life limiting illness and have an anticipated six-month prognosis before the end of their life.
- Hospice is offered when a terminal illness is no longer responding to treatment or when the treatment is significantly impacting the care recipient’s quality of life.
- The focus then becomes on the patient’s comfort and dignity during the dying process.
The Goal Of Treatment
Palliative Care
- A care recipient may opt for palliative care if they’re experiencing unwanted symptoms interfering with their day-to-day life related to their chronic diagnosis.
- The main mission of palliative care is to provide symptom control, pain management, and overall holistic relief to improve the patient’s quality of life.
- Unlike hospice, palliative care can occur alongside curative treatments.
- Palliative care providers can be thought of as consultants who can educate and discuss medical treatment options with patients and families to ensure they understand their options and what treatments are most helpful to them.
Hospice
- The goal of hospice care is to keep the care recipient comfortable as they progress toward the end of their life.
- Hospice care is for when a person stops all curative care. It allows the patient and family to focus on comfort and symptom relief while they progress toward the end of their life.
- Additional goals of hospice include: educating the patient’s family on safe handling techniques and supporting the family throughout the grieving process once their loved one has passed.
The Location Of Care
Palliative Care
- Palliative care can occur in any setting, including the home, hospital, or outpatient facility.
- Palliative care teams are based in a clinic or hospital and can be consulting providers if a care recipient is admitted for a short-term hospital stay.
- A care recipient may also go to palliative care appointments in an outpatient clinic, all while they continue to receive curative treatment for their condition.
Hospice Care
- Hospice care can occur at home, in a hospice facility, or through hospice programs in hospitals or care facilities.
- Home hospice is the most common option for care. Care recipients can remain in the comfort of their homes with their loved ones while hospice nurses and members of the hospice team visit to provide care and recommendations.
- A hospice center is helpful if the patient’s care cannot be managed at home. These care centers are inpatient locations where the hospice team is present and the care recipient can permanently stay until their end of life.
- A hospice program can exist in a long-term care facility or nursing home, where a small number of rooms are designated for hospice care. Hospitals also offer hospice programs. Patients may stay in the hospital and remain on hospice if they’re too unstable to transfer home or to a facility, and death is anticipated in a matter of hours or days.
The Duration Of Care
Palliative Care
- Palliative care has no end date. It can span the length of the care recipient’s life while they’re receiving curative interventions and treatments.
- When treatment is no longer effective, or the quality of life begins to suffer tremendously, palliative care providers may initiate a discussion with the care recipient and family on transitioning to hospice care.
Hospice Care
- To transition to hospice care, a doctor must confirm that a patient has a life expectancy of six months or less.
- After these six months, if the individual has not progressed to the end of their life, a doctor reassesses and re-confirms the need for hospice care in intervals, thus keeping the care recipient on hospice.
- As discussed earlier, all curative treatments have been stopped, so a significantly prolonged hospice period is rare.
- If an individual wants to transition off of hospice, they’re always allowed to make that decision and resume curative treatments and interventions.
Need For Family Support
Palliative Care
- Families are provided some support by the palliative care team including education regarding the care recipient’s condition and treatment options.
- Counselors are often part of the palliative care team and can provide family counseling to help manage stressors associated with having a loved one with a chronic condition.
- Palliative care providers can also help organize the responsibilities of family members to perform caregiving duties like refilling medications or assisting with activities of daily living.
Hospice Care
- Hospice care provides much more family support compared to palliative care, addressing many needs as the loved one progresses toward the end of their life.
- Training. A hospice provider will provide hands-on care to family members to teach them how to assist with things like rolling the care recipient in bed or assisting with medicine delivery. Hospice providers are typically available via phone 24/7 for support and education, but the majority of the care at home is provided by family members, so proper training is essential.
- Equipment. Hospice care providers order and deliver necessary home equipment, such as a hospital bed, supplemental oxygen, or a bedside commode. They also educate the family on how to use the equipment safely.
- Grief support. Social workers and spiritual leaders are often part of the hospice team and can help with grief counseling and bereavement support as families grapple with the process of losing a loved one.
How To Make The Best Decision
Palliative care and hospice care are both patient and family-centered care options that serve different purposes. There is a time and place for each of them, and fully understanding both types of care is essential if you’re deciding which is most appropriate for your loved one. Key factors to remember when making an informed decision include:
- Educate yourself and understand the diagnosis and treatments available.
- Fully grasp the overall prognosis of the condition.
- Consider the wants, needs, and values of care that are important to your loved one.
Deciding to transition to hospice or to receive palliative care is a personal decision that you can make together with your trusted medical team and loved ones.
To learn more about hospice and palliative care, check if you have access to Trualta’s learning library.
References:
- American Cancer Society. (2020, August 5). Who provides palliative care? American Cancer Society. https://www.cancer.org/cancer/managing-cancer/palliative-care/who-provides-palliative-care.html
- CaringInfo. (n.d.). What is the difference between palliative care and hospice care? CaringInfo. https://www.caringinfo.org/types-of-care/what-is-the-difference-between-palliative-care-and-hospice-care/
- CancerCare. (n.d.). Understanding palliative/supportive care: What every caregiver should know. CancerCare. https://www.caregiver.org/resource/understanding-palliative-supportive-care-what-every-caregiver-should-know/
- Hospice Foundation of America. (n.d.). How to access hospice care. Hospice Foundation of America. https://hospicefoundation.org/how-to-access-hospice-care/
- Center to Advance Palliative Care. (n.d.). What is palliative care? FAQ. Center to Advance Palliative Care. https://getpalliativecare.org/whatis/faq/
