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What’s the difference between palliative care and hospice care?


By Toni L. Eaton, RN, BSN, MS

When families and individuals are facing serious medical questions, especially during the stress of a chronic illness or end-of-life decision-making, there are dozens of questions to ask. One that we hear often is about the difference between palliative care and hospice care.

Frequently, the terms are used interchangeably, or people get confused on what the differences really are. But palliative care and hospice care are very distinct services, and it’s worth it to take the time to understand the difference.

Hospice care comes as part of the end-of-life journey. Palliative care can be provided, regardless of the diagnosis, or when a patient is facing a serious illness. Palliative care is based on the patient’s needs, not the patient’s prognosis and it is appropriate alongside curative treatments.

Usually, hospice caregivers are invited in by patients and their families to help make the end-of-life journey in comfort and with dignity. With most hospice agencies, hospice caregivers form a team for each patient. At Old Colony Hospice and Palliative Care, our teams are customized for each patient and each team draws on doctors, nurses, hospice aides, social workers, spiritual counselors, volunteers, and palliative care specialists. The team offers a wide range of support to supplement the care that families give their loved ones.

But a lesser-known fact is that we also have patients who just receive that one part of our name—palliative care. I’ve found in conversations with the public that many don’t realize that palliative care is a piece of hospice, but also a stand-alone service. It is there for people who suffer with chronic illnesses or are in treatment for diseases such as cancer. These conditions, unfortunately, often bring excruciating pain, and palliative care’s most simple definition is “pain management.” Palliative care offers pain relief interventions so people can navigate their lives in the least pain possible.

One of our patients, a middle-aged woman who came to this country from Haiti, was diagnosed with metastatic breast cancer. She and her adult son, who lived with her and was her constant, loving caregiver, worked with her medical team on curative measures, and hospice care was only a distant thought as she battled the disease in hopes of remission. Her family wanted to try every treatment option available. Our palliative care nurse practitioner organized a care plan to help manage her pain every step of the way as she fought, not only the illness, but also the side effects of treatments such as chemotherapy.

Sadly, despite her bravery and her family’s dedication, the patient’s cancer did not go into remission. She and her son had long conversations with our palliative care nurse practitioners about next steps. When the family felt she was ready, they decided to embrace the larger umbrella of hospice care. Our team was there, ready to support and provide care and comfort.

Palliative care is a comprehensive treatment of the discomfort, symptoms and stress of serious illness, and palliative caregivers work with whatever primary treatment you have chosen. The goal is to prevent and ease suffering. Some patients ask us, if they need palliative care, does that mean they’re dying? No. It only means that they are addressing symptoms of pain, such as breathing difficulties or nausea, that often accompany a serious illness and its treatment.

Palliative care can help those living with such illnesses as heart disease, cancer, dementia, lung disease, kidney failure and so many other conditions. Recent studies, including one published in the New England Journal of Medicine, have shown that the improvements provided with palliative care are life giving. Patients with serious illness who received palliative care lived longer than those who did not receive the care.

What is certain with both palliative and hospice care is that you will have the guidance and experience of a team of medical professionals—people who have done this many times before and are committed to what they do—helping you on every aspect of pain treatment, home care, diet, and emotional and psychological care.

Talk to your hospice and palliative care provider, your family members, and your doctor about your goals of care and how palliative care and/or hospice might best improve your quality of life.

Toni L. Eaton, RN, BSN, MS, is the President & CEO of Old Colony Hospice & Palliative Care of West Bridgewater, a dynamic non-profit hospice serving more than 55 communities south of Boston. OCH also runs the Dr. Ruth McLain Hospice Home in Braintree. A native and resident of the South Shore, Toni brings her compassion and experience as a nurse, a veteran, and a community leader to her insightful columns for South Shore Senior News. Her leadership has been honored by several groups, including the South Shore Women’s Business Network.  She currently sits on the boards of the Hospice & Palliative Care Federation of Massachusetts and the National Hospice and Palliative Care Organization Regulatory Committee. For more information, call (781) 341-4145 or visit Old Colony Hospice & Palliative Care.