What is the Difference Between Palliative and Hospice Care?
October 18 2019
From Eligibility to Timing, There are Some Differences Between Palliative and Hospice Care Programs
Many people have heard of and know something about hospice care and the services provided. What can become confusing is that provides palliative care. Where the two are very similar is the most important issue for a person at the end of their life: comfort care. Where hospice and palliative care programs differ is eligibility and when the care takes place, where the care takes place and payment for services.
Eligibility and When Care Takes Place
Hospice care begins with a referral from the primary care physician who considers the patient’s eligibility and condition. To be eligible for most hospice care programs and to receive hospice benefits from your insurance, generally you must be considered terminal or within six months of death.
For palliative care, there are no time restrictions. Patients may receive care at any time or stage of their illness, whether it is considered terminal or not.
Where Care Takes Place
Once enrolled in a hospice care program, a patient’s care is overseen by a team of hospice professionals. Hospice care is most often administered at home and relies on family caregivers as well as a visiting nurse. While round-the-clock hospice care can be administered in a facility such as a nursing home or occasionally a hospital, it is not considered the norm.
Palliative care is overseen by a team of doctors, nurses and other medical professionals and happens at a facility where the patient will first receive treatment. The palliative care team oversees the ongoing comfort-care needs of the patient. Though it is most common for palliative care to occur in a facility such as an extended care facility or hospital, it can be administered at home.
Payment for Services
Because insurance coverage can vary, it is important to take a look at your policy. When considering hospice care, be sure to check on policy limits for payment as well as what is and is not covered. Generally, though it can vary, hospice can be considered an all-inclusive treatment in terms of payment which means that hospice programs cover almost all expenses. For those who are economically disadvantaged or not covered under their own insurance, some hospice programs provided subsidized care. Under Medicare, many hospice programs are covered.
Because palliative care is administered through your hospital or regular medical provider, it is likely covered by your insurance. Do make note, however, that items will be billed for separately, just as with any regular hospital and doctor visits. If you receive outpatient palliative care, prescriptions are billed separately and only covered as provided by your regular insurance. On the other hand, in-patient care often covers prescription charges. Be sure to check with your insurance company for more details about what is and is not covered.
About the Care Administered
Both palliative and hospice services focus on comfort care, however, there are a few differences in treatment. Generally with hospice, the focus is solely on comfort care and getting the most out of what time a person has left, rather than treating the illness. This allows a person to forgo any negative side-effects due to receiving life-prolonging treatments. Through this focus on comfort care, a person can achieve a level of relief that can allow them to focus on the emotional and practical issues of dying.
Because palliative care has no time limits, it acts to fill the gap for patients who want and need comfort at any stage of illness. With palliative care, there is no expectation that life-prolonging treatment will be avoided.
Though these are the general expectations for both hospice and palliative care, there are exceptions to these norms. Some hospice programs do offer life-prolonging treatments and some palliative care programs can offer end-of-life care.
So while both palliative and hospice care programs focus on comfort care, there are differences. Because of these differences, be sure to consult with your primary care physician when deciding which service is right for your needs.