There seems to be some confusion when it comes to understanding the difference between palliative care and hospice. They are both distinctive medical disciplines and often work together.
Hospice care comes into play when a patient has a terminal illness and all treatment options have been exhausted. It is really for those who have been determined to be in their last six months of life. The goal of hospice care is not to cure the underlying disease but to support the quality of life. Hospice care is usually provided by a team of health care professionals who maximize comfort for terminally ill patients while also addressing physical, social and spiritual needs.
Hospice care is most commonly provided at a patient’s home, with a family member typically serving as the primary caregiver, but, it is often available where ever the patient is, whether at hospitals, nursing homes or assisted living facilities. The hospice care team is usually available 24 hours a day, seven days a week.
Palliative care is medical care based on the goal to relieve pain and suffering, reduce symptoms, ease stress, and mainly to improve a patient’s quality of life during a serious illness and is not limited to end of life issues. People who are actively being treated for a disease can receive palliative care at any stage of their illness whereas hospice is thought of as end of life care.
This is an important distinction because many people think of palliative care as end of life care and therefore is often not requested when it’s most needed and helpful. Recent studies are showing the benefits of beginning palliative care soon after the diagnosis of a serious illness or when an ongoing illness worsens.
The palliative care team works closely with the patient’s primary treating physician in caring for the patient. While the patient’s treating physicians may be trying to prolong life, palliative care’s goal is to maximize quality of life. It has been shown that palliative care can actually extend a patient’s life for a number of months.
Identifying and managing pain is one of the main priorities of any palliative care program. Cancer is the most common disease which needs adequate pain control usually with opiate drugs like oxycodone, morphine and its derivatives. Palliative care also seeks to improve many other troublesome sources of physical discomfort such as shortness of breath, constipation, and insomnia.
With the help of a social worker, palliative care also deals with psychological and social services both for the patients and their care givers, as well as helping with practical problems like coordinating doctors visits and even arranging transportation.
Our community is blessed to have a number of top notch palliative and hospice care providers. Talk with your physician for further information.
Terry Hollenbeck, M.D., is a retired urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or e-mail him at
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