Comparing Palliative and Hospice Care

Marc Sweeney
3 min readSep 9, 2021

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While both palliative and hospice care aim to alleviate a patient’s pain and symptoms, the two differ in various ways, including care prognosis and goals, eligibility, insurance coverage, and delivery teams and places.

By definition, palliative care is specialized medical care for people with a serious or life-limiting illness, such as heart failure, cancer, dementia, or chronic obstructive pulmonary disease. It is meant to relieve their symptoms, physical and mental stress and improve the quality of their and their family’s life.

Additionally, palliative care could help patients get better insight into their choices for possible medical treatment. They may receive medical care for their symptoms or curative care for treating their serious illness. Although patients could pursue palliative care at any stage: from diagnosis to curative treatment to end of life, it is most beneficial to start it at the earliest possible stage. Palliative care could commence upon reference by a patient’s health care provider, or the patient could ask for a referral.

Hospice care, on the other hand, denotes specialized care provided to people with an incurable illness. It treats the person and symptoms of the disease rather than the disease itself. Patients who start hospice care know that their illness is unresponsive to medical attempts to cure it or slow down its progression. Alternatively, they might decide to refuse to undergo particular treatments.

In terms of insurance coverage, regardless of whether it is national or private, palliative care costs vary greatly and depend on a patient’s benefit and treatment plan. Meanwhile, hospice care costs are 100 percent covered by Medicare, Medicaid, and private insurance. Furthermore, hospice is Medicare’s single benefit encompassing pharmaceuticals, medical equipment, and 24/7 access to various services such as nursing, social, and grief support.

The delivery teams of both palliative and hospice care are interdisciplinary. They work with the patients, their families, caregivers, and other doctors to provide the corresponding medical, emotional, and spiritual support. The teams often tackle patient’s worries related to becoming dependent, their beloved people’s well-being, and becoming a burden to them. The composition of a palliative care delivery team varies according to the patient’s need and level of required care. Possible members include skilled palliative care doctors and nurses, social workers, nutritionists, and chaplains. A hospice care team, in its turn, could comprise nurses, doctors, social workers, spiritual advisors, and trained volunteers.

As for delivery places, palliative care usually takes place in hospitals. But, it could also be delivered in nursing homes, outpatient palliative clinics, or at home. Hospice care could be provided at home or in home-like hospice centers, assisted living facilities, or veterans’ facilities.

It is important to note that palliative care could transition to hospice care. As mentioned, palliative care includes curative treatment of the patient’s serious illness that could start as early as diagnosis and continue for a long period. However, if, with time, the patient’s physician or palliative care team finds the ongoing treatment ineffective, there are two possible scenarios. The first, palliative care to transition to hospice care provided the physician deems the patient has six or fewer months left. And second, the palliative care team shifts the focus of the provided care to comfort.

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Marc Sweeney

Marc Sweeney — Pharmacy Education, Management, and Consulting