Key Differences Between Palliative and Hospice Care

If you’ve ever cared for a loved one who has been diagnosed with cancer or leukemia or experienced an event that’s life-threatening, you may heard their physicians use terms like curative care, palliative care and hospice care. They’re common terms applied to the care approach we use in latter stages of our lives.

But what do they mean and how are they applied?

Curative Care (also known as Therapeutic Care)

Curative care seeks to cure acute illnesses and heals injuries. This is the kind of care you receive throughout your life.

If the illness or injury is chronic, the goal shifts from full recovering to managing the condition, eliminating symptoms and slowing the progression. The purpose of this care is helping relatively healthy patients live normal, productive lives. 

Curative care includes but is not limited to: 

• Cardiopulmonary rehabilitation
• Casts and splints
• Chiropractic care
• Dental care 
• Dietician services 
• Health education
• Home health
• Kidney dialysis
• Physical therapy
• Podiatry
• Prescriptions 
• Radiation therapy 
• Surgeries
• Vision care

Curative care is very broad. It can be visiting a primary care doctor for a prescription for antibiotics to cure strep throat or a pulmonologist for an annual pulmonary function test. And it’s also consulting a dietician for nutrition counseling or a health promoter for smoking cessation classes.

These services can take place in a doctor’s office, hospital or at your home. Of course, curative care comes with risks and benefits. For example, chemotherapy can cause many side effects, yet can shrink tumors, kill cancer cells and help prevent a recurrence, ultimately prolonging your life. 

Palliative Care

Palliative care is specialized medical care for those living with a serious disease such as:

• Cancer
• Congestive heart failure
• Emphysema
• Dementia
• Chronic kidney disease 
• Parkinson’s disease

 The goal of this treatment is not to cure ailment, but instead to improve quality of life and provide family support. A palliative care team may include physicians, nurses, social workers, dieticians, counselors, support groups, charitable organizations, chaplains and caregivers that work to:

• Relieve pain and discomfort 
• Ease distress, depression and anxiety 
• Improve gastrointestinal symptoms such as poor appetite and nausea
• Alleviate insomnia
• Coordinate care with other healthcare providers
• Assist with advanced directives and portal medical orders
• Render spiritual care

Patients receiving palliative care can continue curative treatments. Care can be rendered in hospitals, patients’ homes, nursing homes and various types of outpatient clinics. Although hospice and palliative care are different, hospice patients also receive palliative care; in fact, hospice is the leading provider of palliative care. Just because you’re receiving palliative care, doesn’t mean you’re need hospice services. It can take years to transition through the stages of palliative care, which include: 

• The first stage, being for stable patients and focusing on developing and implementing a care plan.
• The second stage, focusing on adjusting the care plan and emotional support for patients who are less stable.
• The final stage, for patients in decline and focusses on transitioning the patient to hospice for end-of-life care. 

Hospice Care

Hospice care continues palliative care, but the goals shift to meet the needs of a terminally patient in the last phases of their life. Generally, a patient is referred to hospice care when their doctor believes they have six months or less if the illness runs its natural course. Hospice care reduces costs of end-of-life care for patients and medical providers and improves quality of life. 

Plans of care are designed to manage symptoms and address physical needs; provide emotional care, comfort and spiritual support; maximize quality of life; and provide ongoing support and services for loved ones including bereavement

Hospice care is divided into four stages:

• Home Care – a patient is provided with free equipment, supplies and medication. A member of a specially trained home hospice care team (which may include doctor, nurse, aide, social worker, chaplain or volunteer) visits a patient regularly to make sure they’re comfortable and living with dignity. Home care can be provided in a private residence, assisted living facility or nursing home.
• Continuous Care – if deemed medically necessary, patients receive care from a hospice professional (usually a nurse) continuously for at least 8 hours and up to 24 hours. The purpose is to manage medical symptoms, ease pain and prevent hospitalization.
• Inpatient Hospice Care – if a patient’s symptoms become too much to handle at home, a patient can move into a hospice facility to receive round the clock care by a team of hospice professionals. 
• Respite Care – a patient can spend a brief period in an inpatient hospice facility to prevent caregiver burnout and exhaustion.

Discussing end-of-life care can be difficult, but it helps to understand the terms that physicians and other healthcare workers use. Your primary care doctor may be an advocate and choose to help you navigate care decisions when it comes to palliative and hospice care. Talk to them.

If you don’t have a doctor, consider joining an MDVIP-affiliated practice. MDVIP-affiliated doctors have the time to discuss your healthcare options and guide you through tough decisions. Find an MDVIP affiliate near you and begin your partnership in health »