Palliative vs Hospice Care: Services, Cost, and More

Key Takeaways

• Palliative care aims to ease symptoms and enhance the quality of life at any stage of a serious illness – whether or not curative treatment is still being pursued.
• Hospice care provides comfort-centered support for patients approaching the end of life, usually when curative treatments are no longer viable.
• The two differ in patient eligibility, timing of care, treatment goals, and whether curative treatment is still involved.

When someone is facing a serious illness, there may come a time when curative treatment is limited or no longer an option. At that point, care shifts toward easing symptoms and reducing distress in order to improve, as much as it can, the patient’s quality of life.

Two medical approaches that provide this kind of support are palliative care and hospice care. While both prioritize comfort and compassion, they differ in several aspects, such as timing, eligibility, and treatment goals. Recognizing and understanding these distinctions is essential for helping patients and their families make informed, thoughtful decisions.

What Is Palliative Care?

Palliative care, a specialized form of medical support, aims at improving the quality of life for individuals dealing with serious, chronic, or life-limiting illnesses. This type of care can begin at any stage of the illness, even alongside curative treatments, helping to manage symptoms, reduce stress, and support overall well-being.

What Is Hospice Care? 

Hospice care is known as a type of palliative care designed specifically for individuals who are approaching the end of life, typically when curative treatment is no longer possible or desired. The focus shifts entirely to comfort, emphasizing pain relief, emotional support, and dignity for both the patient and their loved ones.

Key Differences Between Palliative and Hospice Care?

Although both palliative and hospice care aim to increase comfort and ease suffering, they differ in several key areas, including the types of patients they support, the services they provide, team structure, care settings, timing, approach, and payment models. Below, we’ll explore each of these differences in more detail.

Types of patients

Palliative care supports a broader range of patients. It’s offered to individuals living with serious health conditions, including cancer, heart disease, kidney failure, neurological disorders like Parkinson’s or ALS, and chronic respiratory illnesses.

Hospice care, on the other hand, is specifically reserved for patients who are terminally ill and are nearing the end of life.

Services offered

Palliative care services include symptom management (relief from pain, nausea, or breathlessness), emotional and psychological support, coordination of care among multiple providers, guidance in advance care planning, and support for families and caregivers. Because it can be integrated with ongoing medical treatment, palliative care typically plays a supportive role throughout the course of the disease.

Hospice care focuses entirely on comfort and quality of life. It addresses physical symptoms and emotional and spiritual needs, as well as includes bereavement support for families after the patient’s passing. Respite care, which offers temporary relief for family caregivers, is also a crucial component of this area of healthcare.

Team structure and roles

Palliative care is delivered by interdisciplinary teams that may include doctors, nurses, social workers, chaplains, nutritionists, and sometimes physical or occupational therapists.

Similarly, hospice care teams also use an interdisciplinary approach, but in addition to doctors, nurses, and social workers, they also include spiritual advisors, bereavement counselors, and trained volunteers. They focus on delivering round-the-clock, all-inclusive care and emotional support for the patient and their family throughout the dying process and afterward. 

Care settings

Palliative care programs are typically offered within large hospitals or healthcare systems. However, they can also be provided in outpatient clinics, nursing homes, and even at home.

Home-based hospice care is common, as it allows patients to remain in a familiar setting during their final days. That’s why most hospice programs include regular home visits and provide on-call support. However, care can also be delivered in assisted living facilities, hospice centers, or hospitals. 

Timing and eligibility

Palliative care has no set starting point — it can be introduced as early as the diagnosis and continue throughout the course of treatment, even if the patient makes a full recovery. Eligibility is based on the presence of a serious illness and the need for symptom relief or supportive care.

On the other hand, to receive hospice care, a physician must confirm that the patient is expected to live six months or less, assuming the illness follows its typical course. Patients must also agree to forgo any type of curative treatment. This timeframe is reevaluated regularly, and individuals may continue receiving hospice care as long as they continue to meet eligibility requirements.

Treatment approach

In palliative care, treatment for the illness continues alongside symptom management. The focus is on improving the patient’s quality of life without necessarily stopping curative efforts. For example, a cancer patient may receive palliative care to manage side effects while continuing chemotherapy.

In hospice care, however, curative treatment is no longer pursued. Care is entirely focused on managing symptoms, alleviating pain, and providing emotional and spiritual support. That said, treatment for unrelated or chronic conditions, like medication for high blood pressure, may continue if it contributes to comfort.

Payment and insurance

Both palliative and hospice care can be quite costly due to the specialized and continuous support they provide. But insurance definitely can make the cost more manageable.

Coverage depends on the provider and type of insurance. Medicare and Medicaid may cover some palliative care services, particularly if they’re part of a broader treatment plan. Private insurance plans also offer varying levels of coverage. Veterans may qualify for palliative care through the Department of Veterans Affairs.

Hospice care tends to be more consistently covered by Medicare, Medicaid, and most private insurers. Under Medicare, patients are eligible for hospice benefits if a physician certifies a terminal illness with a six-month life expectancy. These benefits typically include medical services, medications related to the terminal illness, equipment (like hospital beds), and counseling support.

Which One Should You Choose?

Choosing between a career in palliative care or hospice care involves making a decision that will impact your ability to support patients during some of their most vulnerable moments. While both fields allow you to provide meaningful care, there are key differences that should guide your choice.

Palliative care is ideal for those who are drawn to managing complex symptoms and developing long-term relationships with patients as they undergo various treatments. 

On the other hand, hospice care requires a special kind of strength, as you’ll be constantly caring for patients nearing the end of life. In this role, you’ll help them find peace and comfort while also supporting their grieving families. Even though they make the journey emotionally challenging, the deep closeness and trust that develop also make it incredibly rewarding.

How to Get Started

Becoming a palliative or hospice care physician involves a similar path, as both careers require rigorous medical training and a strong foundation in compassionate, patient-centered care.

To get started, follow these steps:

1. Earn a bachelor’s degree with a strong focus on science courses like biology, chemistry, and psychology
2. Pass the Medical College Admission Test (MCAT)
3. Apply to medical school
4. Pass the United States Medical Licensing Examination (USMLE)
5. Complete a medical residency program
6. Pursue a fellowship in hospice and palliative medicine to gain specialized training
7. Obtain board certification

Whether you ultimately pursue palliative care or hospice care often depends on the specific focus you choose during your training and clinical experiences.

Conclusion

Both palliative and hospice care demand strength, patience, and deep empathy. You’ll be treating symptoms, but most importantly, you’ll be standing beside people during some of their hardest days. The emotional weight is real, but so is the reward.

At the American University of Antigua (AUA), we prepare future physicians to serve with skill and heart. Whether you’re drawn to palliative care, hospice care, or another medical path entirely, our MD program equips graduates with the training, knowledge, and support they need to pursue their calling.

All medical careers require compassion. All leave a lasting mark. All can be achieved with us at AUA.

Frequently Asked Questions

Is palliative care the last step before hospice?

Not always. At any stage of an illness, palliative care can be introduced and may continue for months or years, even alongside active treatment.

Why do doctors recommend palliative care?

Doctors may recommend it to help alleviate pain, enhance quality of life, and offer support to both patients and their families.

What are the three types of palliative care?

The three main types of palliative care are physical, psychological, and spiritual care.

Why would you be denied hospice?

You may be denied hospice care if you’re not considered to be in the final six months of life or if you choose to continue with curative treatment.