What is the difference between hospice care and palliative care?

aimeee, BSN, RN · Jun 5, 2004

I have been waiting to see if anybody would respond to this, because I have no knowledge of any "palliative care benefit" under Medicare. It has been my understanding that any treatments which are rendered outside the "hospice benefit" would be paid in the same way as curative treatments.

My hospice is now in the beginning stages of planning for a palliative care program so I'm sure I will be learning more about it in the months to come. I'll share anything that comes my way. In the meanwhile, anybody have knowledge about palliative programs they can share with us now?

CCL"Babe", BSN, RN · Jun 5, 2004

From what our family experienced, pallative care is for any patient that has a life threatening illness that requries longterm extensive care. There is no time limit for expected death, but it is expected. Pain issues are addressed as well as physical, occupational therapy and nutritional needs. Social work is involved, nursing as well as other services as needed.

Hospice addresses most of the same issues only there is usually a short life expectancy I think anywhere from 6 months to 6 weeks.

Pallative care is relarively new in the US but has been around for awhile in Europe. That's it to the best of my knowledge, I'm sure I just hit the edges.

dhudzinski · Jun 10, 2004

i initially put this thread under the oncology section because i interviewed in an oncology unit that had 6 palliative care beds. these patients are still receiving treatment....chemo, surgery, radiation. my background in hospice exposed me only to the hospice medicare benefit, which is so much more obviously limited. does anyone here know about services offered under the palliative care benefit? i've written (today) to the csi but if anyone has any info, it would be much appreciated. thanks in advance.
leslie

The difference is huge and yet they are similar. Palliative comes from a latin word Pallido (I think that is the word) any way the latin word means "to cover up" When we palliate we cover up the symptoms in such a way that they are diminished or completely covered and no longer visible.

Palliative care treats the symptoms without curing the illness in any substantial manner. BUT the patient may be seeking active curative treatment such as chemo or radiation treatment or dialysis.

We palliate many illnesses not only those that are "terminal" or "end stage".

Diabetes is palliated via the use of insulin. We "cover up" the effects of diabetes. We do not cure it nor do we change its ultimate outcome.

We Palliate Renal failure through the use of dialysis. We do not cure the renal failure but we cover up the symptoms.

heart disease is also many times palliated with the various medications we use to control or "cover up" symptoms. Hypertension is often palliated. It really is always there we just control or cover up the symptoms. Stop the medications and the hypertension or the heart symptoms "reappear" or "get uncovered"

Hospice is a subdivision of palliative care BUT it is more extensive than palliative care. Hospice is intended for persons with a life expectency of 6 months or less if the disease were to run its normal course. Hospice treats the whole person and the whole family. We do pain and symptom management i.e. palliative care but we also treat the relationships, the spiritual side of the person, Hospice neither extends nor shortens life. The intention of Hospice is to increase quality of life not quantity BUT in palliating the symptoms and in treating the whole person and the whole family we many times extend the life of the person. Patients who do not qualify for hospice can get palliative care and their insurance will cover the treatment costs according to the policy coverage.

Hospice is a philosophy of care NOT a funding source, Although there is a medicare or medicaid hospice benefit. And many private insurances also have a hospice benefit.

I am a nurse consultant for Pain and palliative care. I work with patients who have life limiting illnesses and assist their health care providers with the pain and symptom management of the disease. I also consult with the hospice program for complicated cases.

I hope that I have helped to explain the similarities and differences and answered your question.

leslie :-D · Jun 10, 2004

dhudzinski- thank you....palliative care is very underutilized and is must be marketed so many more people in need can benefit, agree?

dhudzinski · Jun 10, 2004

I wholeheartedly agree. Most people, healthcare providers included do not know about nor understand the benefits of palliative care.

Katillac, RN · Jun 16, 2004

Currently, there is no reimbursement for a palliative care program as there is for hospice care through Medicare, Medicaid or any private insurances that I am aware of. However, organizations that meet certain guidelines are free to set up a program and negotiate with insurance companies for payment.

What that means is there is no comprehensive package being paid for in the name of "palliative care" as there is when a hospice admission takes place and the hospice gets reimbursed for providing a package of nursing care, home health care, social work, spiritual care, volunteers, berevement and medications. That's not to say that people now aren't getting palliative care in the form of the standard care for which insurance companies reimburse.

The beauty of a palliative care program (at least through our agency) is that you also get a case manager and a medical director and nurses who are true experts in symptom management, coordinating what can be a hodgepodge of docs, meds and treatments and providing the 24 hour On Call service to deal with any crisis.

My hospice provides palliative care on a sliding scale and has successfully negotiated rates with several insurance companies. It's tough going, though, because they don't know how to "code" a palliative care service, and until they see that a palliative care program can save them tens of thousands of dollars in hospital admissions for crisis symptom management, they don't want to see outside the box.

sharona97, BSN, RN · Sep 7, 2007

The difference is huge and yet they are similar. Palliative comes from a latin word Pallido (I think that is the word) any way the latin word means "to cover up" When we palliate we cover up the symptoms in such a way that they are diminished or completely covered and no longer visible.
Palliative care treats the symptoms without curing the illness in any substantial manner. BUT the patient may be seeking active curative treatment such as chemo or radiation treatment or dialysis.
We palliate many illnesses not only those that are "terminal" or "end stage".
Diabetes is palliated via the use of insulin. We "cover up" the effects of diabetes. We do not cure it nor do we change its ultimate outcome.
We Palliate Renal failure through the use of dialysis. We do not cure the renal failure but we cover up the symptoms.
heart disease is also many times palliated with the various medications we use to control or "cover up" symptoms. Hypertension is often palliated. It really is always there we just control or cover up the symptoms. Stop the medications and the hypertension or the heart symptoms "reappear" or "get uncovered"
Hospice is a subdivision of palliative care BUT it is more extensive than palliative care. Hospice is intended for persons with a life expectency of 6 months or less if the disease were to run its normal course. Hospice treats the whole person and the whole family. We do pain and symptom management i.e. palliative care but we also treat the relationships, the spiritual side of the person, Hospice neither extends nor shortens life. The intention of Hospice is to increase quality of life not quantity BUT in palliating the symptoms and in treating the whole person and the whole family we many times extend the life of the person. Patients who do not qualify for hospice can get palliative care and their insurance will cover the treatment costs according to the policy coverage.
Hospice is a philosophy of care NOT a funding source, Although there is a medicare or medicaid hospice benefit. And many private insurances also have a hospice benefit.
I am a nurse consultant for Pain and palliative care. I work with patients who have life limiting illnesses and assist their health care providers with the pain and symptom management of the disease. I also consult with the hospice program for complicated cases.
I hope that I have helped to explain the similarities and differences and answered your question.

Thanks for this! Sharona97

Sabby_NC · Sep 7, 2007

The difference is huge and yet they are similar. Palliative comes from a latin word Pallido (I think that is the word) any way the latin word means "to cover up" When we palliate we cover up the symptoms in such a way that they are diminished or completely covered and no longer visible.
Palliative care treats the symptoms without curing the illness in any substantial manner. BUT the patient may be seeking active curative treatment such as chemo or radiation treatment or dialysis.
We palliate many illnesses not only those that are "terminal" or "end stage".
Diabetes is palliated via the use of insulin. We "cover up" the effects of diabetes. We do not cure it nor do we change its ultimate outcome.
We Palliate Renal failure through the use of dialysis. We do not cure the renal failure but we cover up the symptoms.
heart disease is also many times palliated with the various medications we use to control or "cover up" symptoms. Hypertension is often palliated. It really is always there we just control or cover up the symptoms. Stop the medications and the hypertension or the heart symptoms "reappear" or "get uncovered"
Hospice is a subdivision of palliative care BUT it is more extensive than palliative care. Hospice is intended for persons with a life expectency of 6 months or less if the disease were to run its normal course. Hospice treats the whole person and the whole family. We do pain and symptom management i.e. palliative care but we also treat the relationships, the spiritual side of the person, Hospice neither extends nor shortens life. The intention of Hospice is to increase quality of life not quantity BUT in palliating the symptoms and in treating the whole person and the whole family we many times extend the life of the person. Patients who do not qualify for hospice can get palliative care and their insurance will cover the treatment costs according to the policy coverage.
Hospice is a philosophy of care NOT a funding source, Although there is a medicare or medicaid hospice benefit. And many private insurances also have a hospice benefit.
I am a nurse consultant for Pain and palliative care. I work with patients who have life limiting illnesses and assist their health care providers with the pain and symptom management of the disease. I also consult with the hospice program for complicated cases.
I hope that I have helped to explain the similarities and differences and answered your question.

Excellent post and information.

I was going to post my views but you summed it up beautifully. :)

sharona97, BSN, RN · Sep 7, 2007

Looks likw we all went to the same article that is so beautifully expressed! And pretty much at the same time! Shows great support for you Redneck!! Ya hoo.

Allow Mystery · Sep 7, 2007

Thanks for reviving this thread from 2004, it addresses questions I had recently in another thread, and simplifies; interesting that this thread was begun by earle58 back then. Has much progress been made since 2004?

leslie :-D · Sep 8, 2007

Has much progress been made since 2004?

the concept and introduction of palliative care, has made progress, but i have found it to be slow.

in boston, i know of only 3 hospitals that have inpt palliative-care units.

i found an interesting article that explains the differences, how it's typically financed, and when to use hospice or palliative care.

it's from the American Hospice Foundation.

Hospice Care or Palliative Care: What's the Right Care for Me?

http://www.americanhospice.org/index.php?option=com_content&task=view&id=39&Itemid=7

leslie