Palliative care vs. hospice: How to choose the care that’s right for you

Navigating Healthcare

by Dr. Pittman-Hobbs

May 30, 2024

In life, there are moments that call for profound compassion and unwavering support. When you or a loved one is facing serious illness or nearing the end of life, palliative care and hospice care offer solace, comfort and dignity.

Although often grouped together, there are key differences between the experience of supportive palliative care  and hospice care. Let’s explore what each type of care means and how they are both focused on helping people on their health journey.

What is palliative care?

Supportive palliative care (SPC) is focused on providing relief from symptoms for those facing serious or life-limiting illness—even if the illness is not terminal. SPC can be provided at any age and any stage of the illness, alongside any treatment.

SPC is the name commonly used to refer to palliative care, as it brings a more positive connotation, fostering hope and emphasizing the supportive aspect of care.

What is hospice care?

Hospice care is typically for people who have a life expectancy of six months or less (if the illness follows its normal path). For those in hospice care, the focus is truly on comfort care and optimizing quality of life. This shifts away from curative treatments to managing symptoms as someone reaches the end of their life.

How do palliative care and hospice care help people?

The aim of both palliative and hospice care is to improve symptoms. There are often complex physical, psychosocial and spiritual symptoms associated with advanced illness, and the right support can help manage those symptoms to improve a person’s quality of life.

Supportive palliative and hospice care can also support you in sharing the prognosis with others and assist in advance care planning. Both types of care explore grief and coping with transitions through the stages of illness.

Palliative care vs hospice: The differences

SPC and hospice both address physical symptoms, as well as psychological, spiritual and social needs, which can all vary. But there are differences between these two types of care.

Who receives palliative care vs hospice care?

  • Supportive palliative care is appropriate at any age and at any stage for people with serious illness. When someone is living with a long-term illness, it can be beneficial to have a support team of people who are specially trained in how to care for and support them.
  • Hospice is for people and families with terminal and irreversible illness. Hospice is a type of palliative care that is appropriate at the end of someone’s life.

Timing of care

  • Supportive palliative care can be provided at any stage of a serious illness, not just at the end of someone's life. It can begin at the time of diagnosis and continue throughout treatment.
  • Hospice care is typically provided when treatment is no longer effective or desired and the person is nearing the end of life—usually with a life expectancy of six months or less.

Goals of care

  • Supportive palliative care aims to alleviate symptoms, manage discomfort and provide emotional support while people undergo treatment for their illness. It can be integrated with curative treatments, such as surgery or chemotherapy.
  • Hospice care focuses on providing comfort and quality of life for those in their final months, weeks or days. The emphasis shifts from treatment to symptom management and emotional support.

Location of care

  • Supportive palliative care can be provided in various settings, including hospitals, outpatient clinics and even at someone’s home.
  • Hospice care is often provided in someone’s home, but it can also be offered in hospice facilities, nursing homes or hospitals.

Services and support provided

Palliative care involves a multidisciplinary team of healthcare professionals, such as a primary care physician, a social worker, a nutritionist and spiritual caregivers as core team members, as well as specialists like a speech therapist if a person has difficulties swallowing.

Palliative care addresses a broad range of needs, including:

  • Physical, emotional, spiritual and practical support
  • Caregiver support
  • Advance care planning (discussing documents such as a medical power of attorney, living will and do-not-resuscitate orders)

Hospice care provides comprehensive support focused on symptom management, comfort care and emotional support for people and their families. It also often involves a team of healthcare professionals, volunteers and support services tailored to someone’s individual needs.

Overall, while both palliative care and hospice care prioritize comfort and quality of life for people with serious illnesses, their timing, goals and scope of services differ based on a person's individual needs and prognosis. 

Palliative care as a bridge to hospice

In many instances, palliative care serves as the bridge to hospice, so creating an intentional space for communication is crucial. In palliative care, it’s important for the care team to understand what the person knows about their illness and what their preferences are for care, so we can ensure they continue to receive the right support.

In palliative care and hospice, the focus is on providing care that is meaningful and effective and aligns with the person’s health goals and wishes.

If you or a loved one is navigating palliative or hospice care, you’re not alone. We’re here with you every step of the way. Talk to your care team if you have any questions or concerns.

About the Author

Shawnta Renee Pittman-Hobbs, MD, is an internal medicine physician and rheumatologist on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth.

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