How Do Palliative and Hospice Care Differ?
Palliative care is an emerging medical specialty that is often misunderstood. Taken literally, to palliate means to alleviate or soothe. Palliative care focuses on treating the symptoms of serious illness, not on curing the underlying disease. People use the terms hospice and palliative care interchangeably, but there are important distinctions.
Palliative care is an adjunct to other medical treatment that can be given at any time during the course of a serious illness. An interdisciplinary team (physicians, nurses, social workers, chaplains) provides this care and coordinates its work with the physicians who are actively treating the underlying disease. The goal of palliative care is to improve patients’ quality of life by alleviating the physical symptoms of the disease, and providing emotional and spiritual support to patients and their families. Dr. Ira Byock, a leading palliative care physician, explains how palliative care works in his outstanding book, The Best Care Possible.
Hospice care is a form of palliative care. It is possible that a patient who has received palliative care will move to hospice care during the final stage of illness. The goal of hospice is to provide the highest quality of life possible by treating symptoms and providing emotional support to those who are near death. It does not try to cure. In the United States, hospice care is reserved for people who (1) are likely to die within six months, as determined by their physician, and (2) agree to forego curative treatment. Medicare and Medicaid cover hospice care, as do many private insurance plans.
Critics worry that palliative care will be used to reduce the amount of care a patient receives. While on curative palliative care, the team helps patients evaluate the benefits of proposed medical treatments based on their personal goals. These patients may forego treatments with serious side effects and/or unproven efficacy. An MGH study found that patients receiving palliative care had a higher quality of life, were less depressed and lived on average almost 3 months longer than those who receive standard treatment.
Palliative care improves the quality of life for those with serious illnesses and supports the needs of their families as well. People with serious chronic or life threatening illnesses should consider using palliative care, assured that this option will not limit their treatment options.