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Hospice vs Palliative Care

End-of-Life Education

When you or someone you care about is faced with a serious illness, there are a lot of unfamiliar and confusing terms to acquaint yourself with. Sometimes there are subtle nuances between terms that should be explored because knowing the difference could impact one’s quality of life. Hospice and palliative care are two distinct entities that are commonly, and incorrectly, used synonymously. This has led to people not getting the care they need.  

Here are the clinical definitions of each:

Palliative: “Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart failure. Patients in palliative care may receive medical care for their symptoms, or palliative care, along with treatment intended to cure their serious illness. Palliative care is meant to enhance a person’s current care by focusing on quality of life for them and their family.” – www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

Hospice: “Hospice provides comprehensive comfort care as well as support for the family, but, in hospice, attempts to cure the person’s illness are stopped. Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.” – www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

I know, these definitions may still be rather muddy. This is how I look at both of them and hopefully this will help to add some clarity to all of the confusion. Palliative care comes from the word “palliate” which means to ease. Palliative care is all about easing the symptoms of illness, plain and simple. A patient’s age, prognosis or how long they have left to live has no bearing on whether or not they can receive palliative care. This means that if a person falls ill and they need further assistance with symptom control than what they are receiving from their regular health care provider, palliative care might be a wise course of action. Patients can still pursue all of their life saving treatments yet still take advantage of palliative care. It’s just there to help “ease” symptoms, whatever they may be. And more often than not, it’s covered by insurance, so people just need to ask for it. Why people often don’t pursue palliative care is because of the misguided notion that you have to be elderly to qualify or that it’s the same as hospice. And the first thing that people think of when they think of hospice is giving up. Neither hospice nor palliative care should ever be considered “giving up” on life though. 

Instead of focusing on treatments to prolong life, like palliative care, hospice is about focusing on the quality of time one has left. A person is eligible for hospice when they have six months or less to live. Contrary to some beliefs, hospice does not hasten a person’s death through the use of pain medication. Let me be very clear, disease progression is what causes the patient’s decline, all hospice does is manage the symptoms of disease with the hopes of the most comfortable death possible. And just because a person is on hospice does not mean that they can’t improve and go off of hospice care. To the contrary, I’ve known several people, my own father included, who went off hospice because their health improved. So let it be known, hospice is not a death sentence. It’s sad to think of how many people are deprived of all of hospice’s wonderful comfort care services until their last few days of life. 

So if you ever find yourself or a loved one needing medical support, regardless of age or prognosis, there are options that you may not have realized were available to you. Just ask your health care team for more information.

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