Hospice vs palliative care: what's the difference?
The short answer
Both focus on comfort and quality of life. Palliative care can start at any stage of a serious illness, even at diagnosis, alongside treatment meant to cure it. Hospice is a type of palliative care for when a doctor expects about six months or less to live and treatment aimed at a cure has stopped.
General information, not medical advice. Your hospice team knows your person and can answer for your situation.
How are they different?
Both bring a team that works on pain, symptoms, and the stress of serious illness. The main differences are timing and treatment.
- When it starts: Palliative care can begin at diagnosis or anytime after. Hospice is for someone whose doctor believes they have six months or less to live if the illness runs its usual course.
- Treatment for the illness: With palliative care, your loved one can keep getting treatment aimed at a cure. With hospice, those treatments stop and the focus is comfort.
- Where it happens: Palliative care can be given in hospitals, clinics, nursing homes, or at home. Hospice is usually given at home, including a nursing home or assisted living, and sometimes in a hospice facility or hospital.
- Who pays: Medicare covers hospice for people who qualify. Coverage for palliative care depends on your insurance and the treatment plan, so ask the plan.
Why do people mix them up?
Hospice is a specific kind of palliative care, so the words overlap. But palliative care on its own doesn't mean the end is near. People can get it while they are still treating their illness.
The difference matters for coverage. Under Medicare, choosing hospice means choosing comfort care instead of other Medicare-covered treatment for the terminal illness. Care for unrelated problems, like blood pressure medicine, can continue.
How do people move from one to the other?
If treatment is no longer helping, the doctor and palliative care team may talk about next steps. If the doctor thinks your person is likely to die within six months, palliative care can move to hospice. Or the palliative team can keep helping, with more focus on comfort.
Choosing hospice isn't permanent. Your person can leave hospice to try treatment again, and come back later if they qualify.
What can you ask the doctor?
- Is the treatment still helping, and what would it ask of my loved one?
- Would palliative care help now, alongside treatment?
- Do you think hospice could help now, or soon?
- What would change for us day to day with each choice?
It's normal to feel torn. These conversations are hard, and you can ask for time to talk as a family.
Sources
- National Institute on Aging, What are palliative care and hospice care?: nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care
- CMS, Medicare Hospice Benefits (booklet 02154): medicare.gov/publications/02154-medicare-hospice-benefits.pdf
Educational information only. This article is not medical, legal, or financial advice, and it can't account for your person's health or your state's rules. Always talk with your hospice team, doctor, or Medicare (1-800-MEDICARE) about your situation. If you think it's an emergency, call your hospice's 24-hour number or 911.