Related, but different

While hospice care is a part of palliative care, they are not the same thing. The similarities and differences are often the source of confusion, and so here we present a Q&A from The Bellingham Herald’s EndNotes that does an excellent job of explaining:

Q: Last month when my dad was in the hospital, his doctor talked with us about “palliative care” as an option for his congestive heart failure. Can you explain the difference between hospice care and palliative care?

A: These services have some similarities so it is easy to confuse them. A general distinction is that palliative care is need-based, not prognosis-based, while hospice is based on need and prognosis.

Palliative care seeks the relief of symptoms such as pain, stress, anxiety while working to improve the quality of life for the patient and the patient’s family. Palliative care may be offered to anyone at any stage of illness, along with curative treatment.

Patients with chronic conditions, such as congestive heart failure, or even dementia, are often candidates for palliative care. They may end up in the hospital many times over 12 months, presenting the same symptoms which are not curable.

With palliative care, patients are spared often difficult diagnostic tests or futile treatment. Instead, the team seeks quality of life and pain and symptom management as care goals.

When a hospital patient needs palliative care, a consultation occurs with a physician, nurse, social worker, chaplain and the patient with his family. A nutritionist, pharmacist, respiratory therapist, or speech therapist may join the team, depending on the patient’s needs. If a patient returns to the doctor or hospital within a few months, his medical records will identify him as a palliative care patient, ensuring that he receives appropriate care.

Some palliative care patients eventually become hospice patients. Hospice, like palliative care, accepts patients of any age and seeks to control pain, care for the emotional and spiritual needs of the patient and family as well as assist with any transitions between care settings.

However, hospice has specific criteria for their patients: a six-month prognosis is required by Medicare and other insurance providers. Patients receive outpatient medication and supplies, but there is not an attempt to cure the condition or prolong life.

In 2009, 1.56 million people in the United States received services from hospice organizations, with 69 days average length of service. While hospice services are available at some hospitals or stand-alone facilities, most hospice patients remain in their homes, receiving care from nurses, social workers and chaplains who support family caregivers.