Palliative Care vs Hospice: What's the Difference?
Your parent has a serious illness. Someone mentioned "palliative care" or "hospice." Are they the same thing? Should you be worried? What do these terms actually mean?
Many families confuse palliative care and hospice—and that confusion can mean missing out on helpful services. Here's what you need to know.
Palliative care can happen at any stage of illness, alongside curative treatment. Hospice is palliative care specifically for people expected to live 6 months or less who have stopped curative treatment. Both focus on comfort and quality of life.
Side-by-Side Comparison
| Feature | Palliative Care | Hospice |
|---|---|---|
| When | Any stage of serious illness | Terminal illness, prognosis of 6 months or less |
| Curative treatment | Can continue alongside | Generally stopped (comfort focus only) |
| Goal | Improve quality of life while treating illness | Maximize comfort at end of life |
| Location | Hospital, clinic, home | Home, facility, or hospice center |
| Coverage | Insurance, Medicare, Medicaid | Medicare Hospice Benefit (100% covered) |
| Duration | Months to years | Typically weeks to months |
What Is Palliative Care?
Palliative Care
Palliative care is specialized medical care for people with serious illnesses. It focuses on providing relief from symptoms, pain, and stress—whatever the diagnosis or prognosis.
Key points:
- Available at any age and any stage of illness
- Can be provided alongside curative treatment (chemo, surgery, etc.)
- Addresses physical, emotional, and spiritual needs
- Involves a team: doctors, nurses, social workers, chaplains
- Helps with treatment decisions and coordination
- Can continue for years
Who Benefits from Palliative Care?
People living with:
- Cancer (at any stage)
- Heart failure
- COPD and lung disease
- Kidney failure
- Dementia
- Parkinson's disease
- ALS
- Any serious chronic illness
What Palliative Care Helps With
- Pain management
- Nausea, fatigue, shortness of breath
- Anxiety and depression
- Treatment side effects
- Understanding prognosis and options
- Coordinating care between specialists
- Advance care planning
- Family support
Many people avoid palliative care because they think it means giving up on treatment. The opposite is true—studies show that people receiving palliative care often live longer because their symptoms are better managed and they can tolerate treatment better.
What Is Hospice?
Hospice Care
Hospice is a philosophy and type of care for people who are terminally ill with a life expectancy of six months or less (if the illness runs its normal course). The focus shifts entirely to comfort and quality of life.
Key points:
- Requires a prognosis of 6 months or less
- Patient agrees to stop curative treatment
- Covered 100% by Medicare Hospice Benefit
- Can be provided at home, nursing home, or hospice facility
- Includes bereavement support for family after death
- Can be "graduated" from if condition improves
What Hospice Provides
- Medical care: Doctor and nurse visits, medications for comfort
- Equipment: Hospital bed, wheelchair, oxygen as needed
- Supplies: Bandages, incontinence supplies, etc.
- Aide services: Help with bathing, dressing, personal care
- Social work: Emotional support, practical assistance
- Chaplain: Spiritual support of any faith
- Respite care: Up to 5 days in a facility to give family caregivers a break
- Bereavement support: 13 months of grief support for family
Common Misconceptions
Myth: Hospice means you'll die within days
Reality: The average hospice stay is about 3 months. Many people live longer. Some people "graduate" from hospice if their condition stabilizes.
Myth: Hospice means no more treatment
Reality: Hospice stops curative treatment, but continues treatment for comfort. Pain medication, anti-nausea drugs, antibiotics for comfort, oxygen—all continue.
Myth: You can't change your mind
Reality: You can leave hospice at any time and return to curative treatment. You can also re-enroll in hospice later if needed.
Myth: Hospice is only for cancer
Reality: Hospice serves people with any terminal diagnosis: heart failure, dementia, COPD, kidney failure, ALS, and more.
How to Access These Services
For Palliative Care:
- Ask your parent's doctor for a referral
- Request a palliative care consultation if hospitalized
- Search for "palliative care" + your city
- Many cancer centers have palliative care programs
For Hospice:
- Doctor certifies patient has 6 months or less to live
- Patient/family agrees to comfort-focused care
- Choose a hospice provider (your doctor can recommend)
- Hospice team does intake assessment
- Care begins, usually within 24-48 hours
Cost and Coverage
Palliative Care
- Covered by most insurance, Medicare, Medicaid
- Copays may apply like other specialist visits
- Coverage varies by plan
Hospice
- Medicare: 100% covered under Medicare Hospice Benefit
- Medicaid: Most states cover hospice
- Private insurance: Most plans cover hospice
- No hospice is required to turn away patients for inability to pay
When to Consider Each
Consider Palliative Care When:
- Dealing with a serious illness that impacts quality of life
- Experiencing pain or symptoms that aren't well controlled
- Feeling overwhelmed by treatment decisions
- Needing help coordinating between specialists
- Wanting to understand the bigger picture of the illness
Consider Hospice When:
- Doctor says life expectancy is 6 months or less
- Curative treatment is no longer working or no longer wanted
- Quality of remaining life matters more than extending life
- Frequent hospitalizations are no longer desired
- Focus shifts to being comfortable and at peace
Hospice Questions Guide
Get our list of questions to ask when considering hospice, and what to expect from the first visit.
Read the Guide