Hospice Foundation Of America - Palliative Care Defined

Palliative Care Defined

In broad terms, palliative care is any treatment or intervention intended to control pain or other distressing symptoms.

In the context of hospice, palliative care focuses on quality of life rather than curing disease. All hospice care is palliative in that the focus is on controlling distressing symptoms, but not all palliative care includes hospice.

What is the Difference Between Palliative Care and Hospice Care?

Palliative Care	Hospice Care
Specialty care that focuses on symptom management for patients with serious or life-threatening illness, without regard for life expectancy	Specialty care that focuses on quality of life and symptom management for patients with terminal illness, with *life expectancy less than 6 months*.
May continue to receive curative treatment	No longer seeking curative treatment
Emphasis on symptom management	Emphasis on symptom management at end of life
Community-based care	Community-based care
Addresses medical, psychosocial, spiritual and cultural needs of patients and families/caregivers.	Addresses medical, psychosocial, spiritual and cultural needs of patients and families/caregivers
Works collaboratively with current healthcare providers, including specialists	Works collaboratively with current healthcare providers (primarily primary care physician)
Services are not part of a packaged Medicare benefit	Hospice patients can receive the Medicare hospice benefit, including durable medical equipment, and in-patient hospice services/respite care
	Holistic end-of-life care from a multidisciplinary team (including physicians, nurses, social workers, case managers, spiritual counselors, volunteers, bereavement counselors
	Provides bereavement services for family and caregivers

Palliative care in hospice

Pain during terminal illness can be physical, emotional, and/or spiritual in nature and origin.

In hospice, palliative care aims to relieve suffering by managing physical symptoms such as nausea, shortness of breath, and constipation that may be caused by the illness or result from side-effects of medication. Hospice-based palliative care also addresses other issues such as anxiety, insomnia, or depression.

Some hospices offer complementary therapies such as healing touch, meditation, aroma therapy, music therapy, and pet therapy. Non-denominational, non-judgmental hospice chaplains offer opportunity for spiritual exploration and discussion.

Many hospice physicians, nurses, social workers, and home health aides have advanced training and specialized certifications in the provision of palliative care.

**Palliative care without hospice**

Palliative care outside of hospice may be used during any point in the illness. Patients may receive palliative care while they receive treatment aimed at curing or slowing the progression of their disease.

Sometimes such treatments (e.g. chemotherapy, radiation, etc.) can be better tolerated with the help of palliative care, making it a good option for people who are not in the final stages of illness but who desire expert pain and symptom management.

Although transitioning from palliative care to a hospice program when the time is right is not mandatory, many patients elect to do so to access the additional practical, spiritual, and psycho-social support offered in hospice care at end of life.

Accessing palliative care

When someone enrolls in hospice, they automatically receive palliative care. But if you think you might benefit from palliative care outside of a hospice program, ask your physician, nurse practitioner, or physician assistant for a referral to a palliative care provider. Many hospitals now offer palliative care services, and many hospices have palliative care groups that operate separately from their hospice services.

Ask an expert about spiritual support in hospice