Palliative and Hospice Care – What Are The Differences?

Do not confuse hospice with palliative care – they are NOT the same thing.

Some confusion may arise because when a doctor becomes a palliative care physician, they earn a board certification in hospice and palliative care.

As a palliative care specialist, your focus is not just on your patient’s survival, but on his or her quality of life and overall well-being.
-Ricky Persson, GapMedics Blog

Palliative care is specialized medical care for people living with a serious illness. This type of care focuses on relieving the symptoms and stress of a serious illness. The goal is to improve the patient’s and family’s quality of life.

Palliative care is provided by a specially trained team of doctors, nurses, and other specialists who work with a patient’s other doctors to provide extra support. Palliative care is based on the patient’s needs, not on the patient’s prognosis. This care is appropriate at any age and stage in a serious illness, and it can be provided with curative treatment.
-definition from Center to Advance Palliative Care

End-of-life care is not the same thing as palliative care.

Palliative care is essentially adopting a plan of care that aims to control symptoms and provide physical, psychosocial, and spiritual support to patients as opposed to pursuing aggressive treatment that can often worsen symptoms and pain. Improving the quality of life during a time when the patient is going through health issues is a vital aspect of this type of care.
-Definition from Xixuan James Zheng April 30, 2016 Opinion – Berkeley Political Review

Palliative care is required for a wide range of diseases. The majority of adults in need of palliative care have chronic diseases such as cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%). Many other conditions may require palliative care, including kidney failure, chronic liver disease, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological disease, dementia, congenital anomalies and drug-resistant tuberculosis.

Pain is one of the most frequent and serious symptoms experienced by patients in need of palliative care. Opioid analgesics are essential for treating the pain associated with many advanced progressive conditions. For example, 80% of patients with AIDS or cancer, and 67% of patients with cardiovascular disease or chronic obstructive pulmonary disease will experience moderate to severe pain at the end of their lives.
-World Health Organization, 19 Feb. 2018

It is estimated that close to 60% of patients who would benefit from palliative care do not receive it, despite the availability of community and hospital-based palliative care.
June, 2019 NEJM Catalyst Insights Report

There aren’t nearly enough palliative care physicians to fulfill the need for palliative care. There are wide variations across the country in availability of qualified palliative care physicians. In San Diego, studying data from 2016 (Appendix 2), there were 82 hospice/palliative care doctors per 100,000 patients 65 years and older.

- That Good Night: Life and Medicine in the Eleventh Hour by Sunita Puri September 18, 2020
  
  At the end of her training in internal medicine, Dr Puri was doubting the professional choice she had made, questioning if medicine was really what she wanted to do with her life. At the suggestion of a colleague, Dr Puri applied for a position in the palliative care department. She had found her medical passion. At …

- Limitations of Palliative Care July 21, 2020
  
  Retired Palliative Care Nursing Supervisor Beverley Young talks about the limitations of Palliative Care in New Zealand

- The Inescapable Truth September 2, 2019
  
  Opponents of assisted dying often use as an argument that assisted dying is not necessary because good quality palliative care can alleviate suffering at end of life. This report from England concludes that 17 people a day suffer at the end of their lives, despite the best efforts of hospice and palliative care. In research commissioned for …

Even the best palliative care can’t always help September 19, 2013

Neil Frances explains even the best palliative care possible simply can’t help alleviate intolerable suffering for some.

(article courtesy of Hemlock Society of San Diego https://www.hemlocksocietysandiego.org/palliative-care/)

(photos courtesy of https://myaegis.com/palliative-care/what-is-palliative-care/)