As a hospice nurse, I focus on the patient and family in the most holistic manner possible which varies from patient/family to the patient/family.
On the pure medical/healthcare side, we focus on managing presenting symptoms. We do not chase after abnormal vitals, labs, etc.
Part of the holistic side is learning about the patient and family, what's on their bucket list, and how might we aide in the patient/family achieve those items. There's also working through a lot of education as most families including the patient know little about the dying process. So we teach about disease progression, death and dying, and work with the patient and family to get them all to a place of comfort.
Medicare pays for hospice as do a lot of insurances where palliative care typically is out of pocket from my understanding.