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.
| Hospice Care | Palliative Care |
| Specialty care that focuses on quality of life and symptom management for patients with terminal illness, with life expectancy less than 6 months. | Specialty care that focuses on symptom management for patients with serious or life-threatening illness, without regard for life expectancy. |
| Patient is no longer seeking curative treatment. | Patient may continue to receive curative treatment. |
| Emphasis on symptom management at end of life. | Emphasis on symptom management. |
| 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 (primarily primary care physician). | Works collaboratively with current healthcare providers, including specialists. |
| Hospice patients can receive the Medicare hospice benefit, including durable medical equipment, and in-patient hospice services/respite car.e | Services are not part of a packaged Medicare benefit. |
| Holistic end-of-life care from a multidisciplinary team (including physicians, nurses, social workers, case managers, spiritual counselors, volunteers, bereavement counselors. | N/A |
| Bereavement services for family and caregivers. | N/A |
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.
Click here to access the palliative care directory. This link will navigate you away from this website.
