Understanding the Difference Between Palliative Care and Hospice

Based on reporting from UPI Health News and Medical News Today, July 2025

The Confusion is Common

Many people—including healthcare providers—use the terms "palliative care" and "hospice care" interchangeably. But they're actually different types of care with distinct purposes, timing, and eligibility requirements.

Understanding the difference can help you or your loved one access the right care at the right time.

What is Palliative Care?

Palliative care is specialized medical care focused on providing relief from symptoms and stress of a serious illness—at ANY stage.

Key Characteristics of Palliative Care:

Timing:

Can begin at diagnosis, even while pursuing curative treatment

No time limit or life expectancy requirement

Can continue for years

Goal:

Improve quality of life for both patient and family

Manage symptoms and side effects

Provide an extra layer of support alongside curative treatment

Treatment Approach:

Can receive curative treatment AND palliative care simultaneously

Often works in conjunction with oncologists, cardiologists, and other specialists

Focus on symptom management: pain, nausea, fatigue, anxiety, etc.

Eligibility:

Anyone with a serious illness (cancer, heart disease, COPD, kidney disease, dementia, etc.)

No requirement to give up curative treatment

No prognosis requirement

Examples of When Palliative Care Helps:

Cancer patient undergoing chemotherapy needs help managing nausea and pain

Heart failure patient wants better symptom control while still seeing cardiologist

COPD patient struggling with breathlessness and anxiety

Dementia patient and family need support navigating disease progression

What is Hospice Care?

Hospice is specialized care for people with terminal illnesses who have stopped curative treatment and are focusing on comfort.

Key Characteristics of Hospice Care:

Timing:

When curative treatment is no longer effective or desired

Life expectancy of 6 months or less (if disease runs its natural course)

Focus has shifted from cure to comfort

Goal:

Provide comfort and dignity at end of life

Support patient and family through the dying process

Manage pain and symptoms

Prepare for death with peace and grace

Treatment Approach:

Curative treatments are stopped

All care focuses on comfort and quality of life

Comprehensive team approach (doctors, nurses, social workers, chaplains, volunteers)

Eligibility:

Terminal diagnosis with 6 months or less to live

Patient chooses to stop curative treatment

Focus on comfort care only

Physician certification required

Examples of When Hospice is Appropriate:

Cancer patient decides to stop chemotherapy and focus on quality time with family

End-stage heart failure patient wants to be comfortable at home

Advanced dementia patient is no longer eating and approaching end of life

ALS patient in final stages wants symptom management and family support

The Key Differences

| Aspect | Palliative Care | Hospice Care |

|--------|----------------|--------------|

| Timing | Any stage of serious illness | End of life (6 months or less) |

| Curative Treatment | Yes, can continue | No, stops curative treatment |

| Prognosis | No requirement | 6 months or less |

| Goal | Improve quality of life alongside treatment | Comfort and dignity at end of life |

| Duration | Can continue indefinitely | Until death or if condition improves |

| Setting | Usually outpatient clinic or consultation | Home, facility, nursing home, hospital |

| Insurance | Covered like other medical care, may have copays | Medicare Hospice Benefit covers 100% |

Can You Transition Between Them?

Yes! The progression often looks like this:

1. Diagnosis → Begin curative treatment

2. Add Palliative Care → Manage symptoms while still treating disease

3. Continue Palliative Care → As disease progresses, treatment becomes less effective

4. Transition to Hospice → When cure is no longer possible and focus shifts to comfort

Important: You can also:

Stop hospice and return to curative treatment if you change your mind

Re-enroll in hospice later if needed

Receive palliative care without ever enrolling in hospice

Recent Policy Developments (2025)

The Palliative Care and Hospice Education and Training Act (PCHETA) was reintroduced in July 2025, representing federal legislative efforts to:

Advance palliative care education for healthcare providers

Increase access to palliative care services

Improve quality of both palliative and hospice care

Support research and innovation in comfort care

Breaking Down Barriers

Common misconceptions that prevent people from getting help:

Myth: "Palliative care means giving up"

Truth: Palliative care is an extra layer of support WHILE you continue treatment

Myth: "Hospice means death is immediate"

Truth: Many hospice patients live longer than expected with proper symptom management

Myth: "You have to choose between your doctor and palliative care"

Truth: Palliative care works alongside your existing medical team

Myth: "If I start hospice, I can never change my mind"

Truth: Hospice is completely voluntary and reversible

How to Access These Services

For Palliative Care:

Ask your doctor for a referral to palliative care specialists

Contact your hospital's palliative care department directly

Check with your insurance about coverage and copays

You do NOT need to stop treatment to receive palliative care

For Hospice Care:

Talk to your doctor about whether you're eligible

Contact hospice providers in your area for evaluation

Medicare, Medicaid, and most insurance cover hospice at 100%

You can switch hospice providers if you're not satisfied

Recent Expansion in Access

Southern Maryland Partnership (October 2025):

Chesapeake Supportive Care partnered with Southern Maryland House Calls to enhance palliative care access to Calvert County residents, ensuring seniors experiencing progressive illness receive timely and comprehensive care in their homes.

Massachusetts Facility Opening (May 2025):

Mercy Medical Center launched the Andy Yee Memorial Palliative Care Unit, expanding facility-based palliative care options in the region.

The Bottom Line

The key distinction to remember:

> "Palliative care may be recommended at any stage of a chronic or serious illness, while when a patient decides to elect hospice, they often decide to no longer pursue curative therapies."

Both types of care:

Focus on quality of life

Manage symptoms

Provide emotional and spiritual support

Support families

Involve interdisciplinary teams

The right time for each:

- Palliative care: When symptoms need management, even while treating disease

- Hospice care: When cure is no longer possible and comfort is the priority

Don't Wait to Ask

If you or a loved one is facing a serious illness:

1. Ask about palliative care early → There's no downside to getting symptom support

2. Have honest conversations about goals and wishes

3. Know that hospice is an option when the time is right

4. Understand you can change your mind about either type of care

You deserve comfort and support throughout your illness journey—not just at the very end.

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Sources: UPI Health News, Medical News Today, Center to Advance Palliative Care, National Coalition for Hospice and Palliative Care