Understanding the Difference Between Palliative Care and Hospice Care
November is National Hospice and Palliative Care Month. Announced in 1978 by then-President Jimmy Carter, the month was established to recognize the efforts of those providing end-of-life care and raise awareness of the growing hospice movement.
Hospice has come a long way since then. President Carter himself received hospice care before his passing in December 2024. And today, hospice is well-established in the United States and beyond. In 2022, for example, 1.72 million Medicare beneficiaries were enrolled in hospice care, according to the National Alliance for Care at Home.
Despite this progress, many people still don’t know the difference between palliative care and hospice. Both are part of the same medical specialty, complete with post-residency fellowships and, since 2006, Board certification. And while both prioritize comfort, dignity, and quality of life for those with serious illnesses, they differ in timing, care goals, and the settings where care is provided. Understanding these differences can help families choose the type of support that best meets their needs.
In honor of National Hospice and Palliative Care Month, this blog offers a primer on these two distinct types of care, exploring what they involve, when they may be appropriate, and who can benefit from them most.
Important Takeaways
- Both palliative and hospice care prioritize comfort, dignity, and quality of life during serious illness.
- Palliative care can begin at any stage of illness, often alongside curative treatments.
- Hospice care begins when illness is life-limiting (terminal) and curative treatments are no longer effective or desired.
What Is Palliative Care?
Palliative care is a medical specialty that provides comfort, education, and support for people living with serious illness. It focuses on relieving pain, easing symptoms, and reducing the stress that often comes with treatment or recovery. The goal is to help patients live as comfortably and fully as possible—physically, emotionally, and spiritually—while supporting those who care for them.
Unlike hospice care, palliative care can begin at any stage of illness, and it often occurs alongside treatments aimed at curing or slowing the progression of a disease. A patient may continue chemotherapy, surgery, or other therapies while receiving palliative care to manage symptoms and side effects and maintain their quality of life.
Palliative care teams are made up of physicians, nurses, chaplains, social workers, and other specialists. Working together with a patient’s existing doctors, this team helps patients and families understand the illness, consider treatment options, and make informed decisions that reflect their unique values and goals. This support can also extend beyond medical care, connecting families with community resources or practical assistance to help make daily life a little easier.
“Palliative care is different from hospice care because it is appropriate for people who are seriously ill and are continuing treatment. With exceptions, such as continuing routine medications for problems like high blood pressure or diabetes, people in hospice care are no longer being treated for serious or terminal illness. For example, people in hospice care are not treated with chemotherapy or radiation for cancer, and focus instead on the relief of symptoms.”
Dr. Joseph Sacco, Chief Medical Officer, The Connecticut Hospice
What Is Hospice Care?
Hospice care is a form of palliative care for patients nearing the end of life, when treatments to cure or slow an illness are no longer effective or desired. At this stage, the focus turns entirely to comfort, dignity, and quality of life for patients and their families.
Because hospice is a form of palliative care, it follows the same whole-person philosophy. It addresses every aspect of well-being—physical, emotional, and spiritual—and provides coordinated support for both patients and caregivers.
A dedicated team of physicians, nurses, chaplains, and trained volunteers works together to ensure expert symptom management, guidance through complex decisions, and companionship through the final stages of illness. Families also receive practical and emotional support, including bereavement services, after a loved one’s passing.
What’s the Difference Between Palliative Care and Hospice Care?
Palliative and hospice care share the same foundation: comfort, dignity, and support for people living with serious illness. The main difference between palliative care and hospice lies in when they begin, what they prioritize, and how they are structured.
Timing and Care Goals
Palliative care can begin at any stage of a serious illness, even at diagnosis. It is designed for patients still receiving active treatment and helps manage symptoms and side effects while maintaining comfort and quality of life.
For instance, palliative care for cancer may prioritize easing pain, nausea, or fatigue while continuing treatments aimed at fighting the disease.
Hospice care, by contrast, begins in the final stages of a serious illness. A physician must certify that the patient’s life expectancy is six months or less (assuming the illness follows its typical course). The patient and their care team must also have determined that they are no longer responding to or interested in receiving curative treatments.
It’s important to note that choosing hospice care doesn’t mean discontinuing all other medical care. A person who decides to stop chemotherapy, for example, may still take medication for underlying health conditions while receiving different treatments for comfort and well-being.
Care Teams and Services
Both palliative care and hospice care are provided by interdisciplinary teams that may include physicians, nurses, social workers, chaplains, and trained volunteers.
Palliative care teams collaborate with a patient’s existing doctors to manage symptoms, relieve the side effects of treatment, and offer emotional and spiritual support. The goal is to improve day-to-day comfort and help patients live as fully as possible while continuing medical treatment.
Hospice teams, meanwhile, take a central role in coordinating care during the final stages of illness. As a specialized form of palliative care, it includes many of the same supports—symptom management to ensure comfort, emotional and spiritual care, and family guidance—while also offering services unique to end-of-life care. These may include education about what to expect, respite care for family caregivers, and bereavement support following a loved one’s passing.
Coverage and Funding
Coverage for palliative care varies depending on a patient’s insurance, treatment plan, and location. Many private insurers, as well as Medicare and Medicaid, cover some or all palliative services provided in hospitals, skilled nursing facilities, outpatient clinics, or home-based programs.
Medicare finances most hospice programs at no cost to patients, though many other insurers, including Medicaid, offer hospice benefits. Every Medicare-certified hospice must provide a full range of services (skilled nursing and medical services, social work, chaplaincy, volunteer support, and other professional services) to enrolled patients, ensuring they and their families receive comprehensive care and peace of mind.
Care Setting
Palliative care can be provided in outpatient settings (home, clinics, or community facilities) or inpatient settings (hospitals or specialized care units), depending on a patient’s needs and stage of illness. In fact, patients may transition between different care settings as the disease progresses or improves.
Similarly, hospice care is delivered in multiple settings, including at home, in assisted living or skilled nursing facilities, and in dedicated hospice centers. While some medical needs may require inpatient attention, the goal is to provide care in the environment where patients feel safest and most comfortable.
Palliative Care and Hospice: Stories of Compassion in Action
At the heart of palliative care is compassion—a desire to relieve discomfort, worry, and pain. Two patients’ stories, as told by a Connecticut Hospice physician, exemplify the specialty’s profound impact and ability to restore quality of life.
I had the privilege of providing palliative care to two patients whose experiences exemplified the specialty at its best.
One, a woman in her fifties, was diagnosed with a malignancy and referred to a home palliative care program I worked with. She was suffering from pain and anxiety, and the nurses, social workers, and I collaborated to provide her relief from these symptoms with counseling, support, and medications. Literate, educated, and a self-starter, she then set about finding a leading physician to offer treatment for her disease.
When she returned from her first appointment, she was confused.
“What did he say?” I asked during a home visit.
“I didn’t understand a word of it,” she told me, exasperated. “I’m not even sure he was speaking English.”
This was not at all uncommon. Though well-intended, doctors often struggle to make medical information understandable for their patients, who typically do not have medical training. Palliative care doctors specialize in exactly this kind of conversation.
“Would you like me to call him and find out what he can do for you and let you know?” I asked.
She did. I returned to her home a few days later and got straight to the point, cutting through the medical esoterica that had characterized my discussion with the surgeon—and, apparently, what he had told her. “The surgeon said you have a better than 80% chance of being cured with an operation,” I told her.
“Would you do it?” she asked.
“Those are pretty good odds,” I said. “I’d go for it.”
That was more than five years ago. I still get Christmas cards from her. Now cured, she has returned to her life and no longer needs palliative care.
The second patient was a man in his late 60s. Retired, he had recently lost his beloved wife, and he was suffering from advanced cancer that left him fatigued and mostly unable to get up from the couch in his living room. He’d been living with cancer for 10 years; his oncologist had managed again and again to find a treatment to prolong his life.
He had thought about his condition and was direct about his wishes. “So long as my doctor can keep my cancer in check,” he told me, “I’m going to keep getting treated. But when it stops working, I’m going to enroll in hospice so I can die in comfort.”
I was impressed by his decisiveness. “What do you like to do?” I asked. “For fun?”
“Fish,” he replied, without hesitation. “Trout. Catch and release. I even have a blog. But I’m too tired for that now. I can barely get off this couch.”
I had some tricks up my sleeve. I started him on a brief course of high-dose corticosteroids and amphetamine. In short order, he virtually leapt from his couch, donned his floppy fishing hat and khaki vest, festooned with flies he had tied himself, climbed into his pickup truck, picked up his son, and spent a day catching trout and throwing them back into one of his favorite fishing spots.
When we stopped the medications, he flopped back on his couch. Six months later, he was admitted to our inpatient hospice facility. Treatment was no longer holding back his cancer, and he had worsening shortness of breath.
I stopped by his bedside on the morning of his admission. “How can we help?” I asked.
He answered with his characteristic lack of hesitation. “I want to stop feeling short of breath, I want to see my son get married, and I want to die in peace,” he replied.
I looked at his son, who stood on the opposite side of the bed. “When are you getting married?” I asked.
“In three months,” he replied.
Later, we spoke in the hall. “You’re getting married tomorrow at your dad’s bedside,” I told him.
“I think you misunderstood, Doc,” he said. “I’m getting married in three months.”
“I understood,” I said, “but I’m asking you to get married tomorrow at your dad’s bedside.”
He and his fiancée married the following day in a ceremony attended by most of the hospice staff. He wore a tuxedo; she, a wedding gown. There was music, dancing, and champagne—right in his father’s room. His father could not stop smiling. He died peacefully the following day.
Find Relief and Comfort
Palliative care is about helping you live as fully and comfortably as possible, no matter where you are in your illness. At Connecticut Hospice, our compassionate team works alongside you and your loved ones to manage symptoms, provide guidance, and support your emotional and spiritual well-being—so you can focus on the moments that matter most.
To learn more about palliative care for yourself or a loved one, reach out to our team today. We’re here to answer your questions, explore your options, and connect you with the support that fits your needs.
