Many older Americans develop serious health conditions that can cause incredible pain, discomfort, and debilitation. When these illnesses arise, it is essential to plan ahead so that your end-of-life wishes are honored. Understanding your options and the differences between palliative care and hospice is important. Both hospice and palliative care provide comfort care, but palliative care allows for curative treatments, whereas hospice requires stopping all treatment for your illness. 

What is palliative care?

Palliative care is a specialized treatment for people with serious illnesses. It focuses on improving your quality of life by addressing physical, emotional, and spiritual needs throughout your illness. Palliative care can occur alongside treatments to cure your condition and often provides medical care for symptoms of the disease and side effects treatments. For example, someone with cancer may receive chemotherapy to treat the disease while simultaneously receiving palliative care to help manage pain or nausea caused by the chemotherapy. 

A palliative care team, including doctors, nurses, social workers, nutritions, chaplains, and other professionals, coordinates the care you need. It provides support for the patient and their families throughout treatment. 

Who needs palliative care?

Candidates for palliative care include people diagnosed with severe illnesses such as cancer, heart failure, COPD, Parkinson’s, dementia, and other illnesses that can cause debilitation or extreme discomfort. Anyone dealing with pain and discomfort from disabilities later in life can receive palliative care to help improve their quality of life and manage disease symptoms.

Where is palliative care provided?

Palliative care can be provided in a variety of settings. Some patients receive palliative care in a hospital, nursing home, or assisted living facility. Palliative care clinics and other specialized clinics can also provide palliative care services. You may even receive palliative care at home, which allows some patients to feel more comfortable than they would in a hospital setting. 

Is palliative care covered under Medicare?

Medicare covers palliative care. Original Medicare and Medicare Advantage pay for inpatient hospital stays, doctor visits, mental health counseling, and necessary durable medical equipment such as hospital beds. If you have prescription drug coverage from a Medicare Part D or Medicare Advantage plan, your medications may also be covered under those plans. Deductibles, copays, and coinsurances may apply for palliative care services. 

What is hospice?

Hospice care focuses solely on comfort and quality of life for those with a terminal illness or condition who doctors think only have a short time to live (usually six months or less). Hospice patients either have a disease that does not have a cure or choose not to undergo treatment. 

When hospice care begins, all curative treatment stops, and care focuses on alleviating discomfort and improving quality of life. This does not mean you stop taking any medication. For example, patients can continue medications such as blood pressure medications or other daily medications that are not curative but do improve their quality of life.

A hospice team provides hospice care. This team can include doctors, nurses, social workers, spiritual advisors, and trained volunteers. The hospice team specializes in end-of-life care and replaces your usual healthcare provider. 

Who needs hospice care?

Hospice care is for people who have a terminal illness or condition that does not have a cure. It is also appropriate for people with a serious illness who choose not to undergo or stop current curative treatments, such as chemotherapy, for cancer patients. 

Where is hospice care provided?

Hospice care can take place at home or in a facility such as a hospital, nursing home, or specialized hospice care home. If you are more comfortable at home, you can use a home health agency that specializes in hospice care.

Is hospice care covered under Medicare?

Medicare covers hospice care if you meet hospice eligibility requirements. You meet the requirements if you meet all of the following:

  • Your doctor or healthcare provider has determined that you have less than six months to live

  • You decline all curative treatment

  • You sign a statement requesting hospice care over other Medicare-covered care

If you have Medicare, you pay nothing for hospice care. A $5 copay applies for outpatient medications filled at your pharmacy. Respite care, an inpatient stay that allows your regular caregiver to rest, is covered with only a 5% coinsurance cost. 

If you live in a facility (like a nursing home), you may still need to pay for your room and board.

How are hospice and palliative care similar and different?

While both types of care put patient comfort first, some critical differences exist between hospice and palliative care. Knowing how they compare can help you and your family decide which type of care is best for your needs. 

Key similarities between hospice and palliative care

With both hospice and palliative care, the overall goal is to reduce pain and discomfort, honor and value the patient’s wishes, and offer individualized care to meet these wishes. Both options offer more than just medical care by providing a team of caregivers, including chaplains, social workers, and other professionals who coordinate care. 

Hospice and palliative care are offered in various settings, including in your home. They offer supportive services and include the patient and family in decision-making regarding end-of-life care. You have the option to discontinue either type of care at any time.

Key differences between hospice and palliative care

The most important difference between hospice and palliative care is that palliative care allows for curative treatments to continue alongside comfort care. Choosing hospice care means you will no longer pursue treatments to cure your illness or extend your life. The sole focus is on comfort. 

The length of treatment also differs. Palliative care can occur continuously for long periods or may be intermittent if your condition changes. Hospice care typically occurs continuously until the end of your life, generally for six months or less. 

Both palliative and hospice care improve the quality of life for patients with serious medical conditions. Many times, palliative care can be a transition into hospice care. When palliative care is unsuccessful in curing a condition, some patients transition to hospice care to focus solely on comfort until the end of life. 

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