There comes a time in the life of every person when what they need most is simply relief; for someone to take away the pain, the stress, and the burden. In the world of senior care, there are two similar but separate courses of care that a caretaker (be they a family member or a professional) should be aware of; palliative care and hospice care. There are similarities and differences between the two, which we will discuss in further detail below.
A ‘palliative’ is any medicine or procedure that has the purpose of relieving pain and stress, but does not (necessarily) do anything to address the cause of that pain and stress. Palliative care, as you might guess, is similar; it is any care given to a person that is not targeting the cause of their problems, but only the most debilitating symptoms of the problem.
A ‘hospice,’ by contrast, is a place; a place where people who are going to pass away soon and cannot be cured are taken to be cared for until the end comes. Hospice care provides the same function, but is removed from the location; hospice care can be provided at home, in a hospital, or elsewhere, but is fundamentally aimed at providing the highest quality care for those who are approaching their final days.
For all intents and purposes, what a hospice (the location) offers is palliative care; if someone is going to pass away and nothing can be done about the cause, palliative care is literally the only kind of care that can be offered. So in one clear respect, hospice care is effectively a subset of palliative care. However, there is more to palliative care than hospice care, and there is also more to hospice care than just palliative care.
Palliative care is hardly restricted just to those people who have a terminal illness or injury. Anyone who is suffering can receive palliative care, and in fact most do; palliative care is offered by almost every hospital, every senior care center, and most other medical facilities as an adjunct or supplement to the typical array of standard care options. For many patients, most of the medicines, day-to-day care, and even many procedures are considered palliative, because palliative is essentially the medical opposite of curative.
Meanwhile, hospice care is entirely palliative for the patient, but hospice care extends beyond just the patient being treated. The entire family is the “unit of care” that hospice care targets. There are significant elements of bereavement counseling, spiritual guidance, relationship mending, social work, and community resourcing that goes into hospice care.
Perhaps the most important difference between palliative care and hospice care are the payment and eligibility for services associated with each.
The Technical Details
Palliative care is not something that a patient needs to ‘qualify’ for; the doctors, nurses, and other caregivers at virtually every medical facility on Earth are trained to give palliative care as part of the normal routine. In some places (notably some nursing homes) a defined ‘palliative care team’ exists to provide specialized relief for people with particularly disabling acute pain or particularly stubborn chronic pain.
It is possible, with some kinds of insurance and working with certain caregivers, to have a palliative care expert or team assigned to your home by a home health care service. Palliative care is paid for as part and parcel of a standard treatment, by whichever entity is paying for that treatment.
Hospice care, by contrast, requires a referral from a patient’s primary care physician (PCP) in order to enroll. Generally, hospice care is administered by a team of professional hospice specialists, and is performed in the home or residential facility where the patient resides. In rare cases, a nursing home or hospice-specific facility will provide round-the-clock hospice care, but only for patients that are almost certainly within a few days of death.
In order to get a hospice referral from your PCP, you must have a disease generally considered terminal, or have less than six months to live according to the physician’s professional opinion. In addition, it is important that the family caregiver check carefully over a patient’s insurance policy before committing to hospice care; some policies have unpredictable gaps or odd exclusions involving hospice coverage. If the patient is on Medicaid or Medicare, most hospice programs are covered.
In the end, if you have an honored elder that is in crippling pain, often the best you can do for them is find a way for them to be able to live free of that burden. Whether it is palliative or hospice care, it is important to be committed to providing optimal quality of life while they live out their final days.