What is palliative care? How is it different from hospice?

Palliative care is specialized medicine for people with serious illnesses designed to improve their quality of life and that of their loved ones. Palliative care helps with physical symptoms such as pain, nausea and fatigue and provides emotional support to the patient and their family.

Patients often have not heard about palliative care. The term “hospice” is sometimes used instead of “palliative care,” in part because hospice is the more recognized of the two terms. But palliative care and hospice do not mean the same thing.

The key difference between hospice and palliative care is timing and treatment.

Differences between palliative care and hospice

• Palliative care focuses on maintaining the highest quality of life while continuing treatment. It concentrates on other needs, such as symptom management.
• Hospice care focuses on care and pain management, but not treatment when a cure is no longer possible, or the burdens of treatment outweigh the benefits. Patients can be enrolled in hospice when their doctor believes they have less than six months to live.

How palliative care helps

“I like to say, we're the help our patients need that they didn't know they needed,” says Anglice Hollins, medical assistant with Sentara Supportive Care Services, which provides palliative care. “We’re not looking at the end of your life. We’re helping you feel better in what you’re doing day-to-day.”

Many people have misconceptions about palliative care.

“That can create a barrier to people seeking services that might help them,” adds Jared Kobulnicky, M.D., a medical oncologist with Virginia Oncology Associates.

Palliative care is provided by a team that may include doctors, nurses, social workers and advanced care practitioners such as nurse practitioners and physician assistants and includes support with:

Symptom management

• A thorough symptom assessment and expert management to improve your overall quality of life
• Personal medication management, alternative therapies and tips to help with symptoms with an emphasis on prevention as well as treatment

Communication and planning tools

• Creates a care plan identifying your personal needs and the various support available to help you meet your health goals
• Creates space for an open dialogue between you and your doctors and your loved ones
• Supports the day-to-day needs of you and your caregivers, such as help with medication management
• Provides guidance in making complex and difficult treatment choices

Emotional and spiritual support

• Help you and your family through the emotional challenges of living with a serious illness.
• Encourage you and your family to ask questions and share concerns.
• Ensure your beliefs and values are represented with the inclusion of spiritual support if desired.

Physical care

• Looks after your body's needs through things like mobility aids and exercises

Who should consider palliative care?

Cardiovascular diseases, cancer and chronic obstructive pulmonary diseases are the most common conditions of patients receiving palliative care, but many other serious illnesses may be supported by palliative care.

Reasons to consider palliative care:

• You’re experiencing symptoms such as pain/discomfort, shortness of breath, fatigue, appetite changes, nausea, depression and anxiety that are impacting your quality of life
• You’ve experienced multiple hospitalizations in the last six months
• You have the desire to get help documenting healthcare wishes such as advance care planning needs and goals of care

Palliative care doesn’t replace current health treatment

“Palliative care is meant to be an additional layer of support and symptom management on top of the treatments already occurring,” says Lindsey Hunt, M.D., with Sentara Palliative Care Specialists. “When you see your oncologist or your cardiologist, their focus is on that organ. With palliative care, we can zoom out and deliver more whole-person centered care.”

Family and caregiver-focused

Another unique quality of palliative care is its attention to the patient’s family, loved ones and caregivers.

“We’re the only medical specialty in which, as the doctor, I'm actually supposed to check in with the family, too,” says Dr. Hunt.

“Palliative care isn’t just a patient's journey,” adds Jo-Marie Ewell, R.N., and head and neck navigator with Sentara Oncology.

“Palliative care is for everyone who loves that person. It's part of their journey, too,” Ewell says. “That additional support is for the family and lets them know they’re not alone.”

When to start palliative care

The sooner a patient with a serious illness starts palliative care, the more it can help. Studies have shown that people with chronic illnesses who engage with palliative care have a better quality of life, less pain and fewer symptoms such as nausea.

“We want earlier palliative care consults because the goal is to create a care plan around our patient's goals and health values,” explains Dr. Hunt.

Starting palliative care earlier in a serious illness can help with:

• Better symptom control, for example, anticipating symptoms and having tools and prescriptions in place ahead of time
• Support for significant treatments such as surgery or chemotherapy
• Care focused on physical aspects of the illness but also on coping skills and psychosocial concerns
• Advice for the family, loved ones and caregivers so they can best support the patient
• Help with anxiety earlier in the diagnosis
• A review of the patient’s care plan, from easy days to difficult days

How to connect with palliative care

A referral is needed for palliative care. Start the palliative care journey by speaking to your healthcare team about a referral to a palliative care specialist. Find out more about palliative care services in your community.

You can also take our online quiz to determine whether you or a loved one would benefit from palliative care.