The short answer
Palliative care is comfort-focused care that can begin at any point in a serious illness, at any age, and alongside treatment intended to cure or slow the disease. Hospice is a specific insurance benefit for people whose prognosis is limited and who are no longer pursuing curative treatment for the terminal illness. Hospice always includes palliative approaches; palliative care is not always hospice.
One clarification
Hospice of Grace provides hospice care. If what you need is palliative care alongside active treatment, ask your physician or the hospital for a palliative care referral, and ask us how the two services would work together if you are unsure which fits.
Side by side
| Palliative care | Hospice care | |
|---|---|---|
| Timing | At any stage of a serious illness | Generally a prognosis of six months or less |
| Treatment intent | Can continue alongside curative treatment | Curative treatment for the terminal illness stops |
| Where | Hospital, clinic, or sometimes home | Wherever the person lives, or a facility |
| Who pays | Billed to insurance like other medical care | Covered under the Medicare hospice benefit, Medi-Cal, or private insurance |
| Who provides it | Palliative care teams, often hospital-based | An interdisciplinary hospice team |
| Can it stop? | Yes, at any time | Yes, patients can leave hospice |
Which one fits right now
If the person is still receiving treatment intended to cure or control the disease, and the main need is relief from symptoms and stress, palliative care is usually the better fit.
If treatment intended to cure has stopped or is no longer helping, and a physician believes the prognosis is limited, hospice is likely appropriate. Hospice brings the team into the home and covers medications, equipment, and support that palliative care clinics often do not.
Some patients move from palliative care into hospice as the illness progresses. That is the intended path, not a failure of either model.
Two myths worth correcting
The first is that palliative care means giving up. It does not; it is given alongside treatment, often early in an illness, and has been shown to improve quality of life.
The second is that hospice is only for the last days. Many patients are on hospice for months, and earlier enrollment generally means better symptom control and less crisis.
Common questions
Can someone receive palliative care and hospice at the same time?
Not usually through the Medicare hospice benefit, which already includes palliative approaches and is elected instead of treatment intended to cure the terminal illness. Some patients receive palliative care first and transition to hospice later.
Does hospice mean no treatment at all?
No. Hospice focuses on comfort and quality of life. Under the Medicare hospice benefit, patients choose comfort care instead of treatment intended to cure their terminal illness and related conditions, and some treatments used to relieve symptoms may still be considered. Treatment for unrelated conditions continues.
Who can refer someone to palliative care?
Usually a physician, but in many health systems patients and families can ask for a palliative care consult directly. Ask the hospital or your primary physician.