What’s the difference between hospice and palliative care?

Question

I’ve seen palliative care described as symptom-relieving treatment *usually* for terminal diseases, though it doesn’t have to **only** apply to terminal diseases. Doesn’t that make pretty much ALL medical treatment “palliative care”? Say if someone has epilepsy and they are treated with anti-seizure medicine to stop their seizures, would that fall under the definition of palliative care?

In: 8

Answer 1

This is an area I’m super passionate about because I treat a lot of palliative and hospice patients.

Palliative is an approach. Hospice is a plan.

Palliative care means to manage the symptoms of a life limiting illness without the ability or intent to cure it. Progressive neuromuscular diseases (ALS, like Stephen Hawking, for example) are certainly life limiting, but cannot be cured. Even in the early stages of the disease, before any significant symptoms, the approach is palliative. We know the patient is going to die from this illness, but at this time we can’t do anything about it. Instead of focusing on how long someone will live, we will focus on how well they will live. Whether it is massage therapy, pain medication, even blood transfusions. All of these treatments provide the patient the best years possible, not necessarily the most years possible. We will certainly treat anything curable that comes up. We won’t let you die of infection if we can treat it, we just can’t cure the primary illness.

Hospice is what we call “End of life care”. For an expected death, hospice care focuses on providing the most peaceful final weeks/days/hours possible. In this setting, there are no limits on pain medication (a practitioner is still liable if their error or negligence caused death), no concerns over off label use of other medications. Just the most comfortable and peaceful final time possible. Hospice usually refers to a specific place, but end of life care may take place anywhere. I’ve spent hours in patients’houses providing this type of care.

Hospice/End of Life Care is a part of the palliative approach and represents just one part of the specialized care provided by palliative specialists.