Palliative Care vs Hospice: What Families Need to Know

When a loved one is facing a serious illness, families are often introduced to terms like “palliative care” and “hospice care.” While these two types of care share similar goals, they serve different purposes and are used at different stages of a patient’s journey.

In this episode of Take Care, Melody shares her family’s personal experience navigating care decisions for her 91-year-old father-in-law, who is living with late-stage Parkinson’s disease. She explains the important differences between palliative care and hospice, what each one focuses on, and how families can better understand these options when talking with healthcare providers.

Melody also discusses how palliative care can work alongside active treatment, while hospice care focuses entirely on comfort and quality of life during end-of-life care. This episode offers compassionate guidance for caregivers, adult children, and anyone supporting a loved one through difficult medical decisions.

What You’ll Learn in This Episode:

• The difference between palliative care and hospice care
• When palliative care may be appropriate
• How hospice focuses on comfort and dignity at the end of life
• Why palliative care can happen alongside treatment
• How families can navigate difficult healthcare decisions with confidence

Timestamps:

[00:00] Why Melody’s family is navigating palliative care vs hospice
[01:20] What palliative care actually means
[02:45] How palliative care can happen alongside treatment
[03:20] What hospice care focuses on
[04:20] Real-life hospice experience with Melody’s mother-in-law
[05:00] Treatments possible during palliative care vs hospice
[05:40] Where hospice and palliative care can take place
[06:10] Why hospice can be a compassionate and relieving choice
[06:45] Can patients transition from palliative care to hospice?
[07:10] Encouragement for families facing difficult care decisions

If you’re caring for an aging parent or supporting a loved one through a serious illness, this episode will help you better understand the difference between palliative care and hospice so you can make more confident, informed decisions for your family.

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Transcript

Melody 0:12

Hello everybody, and welcome to this episode of Take Care. I have not abandoned my short Q&As. I know I've been doing a lot more, a little bit longer interviews, and will continue to do that. But I will also still be sprinkling in the shorter Q&As based on questions that I'm getting or situations that we're dealing with in our household specifically. So, this week I wanted to talk about a really good question of education of what is palliative care versus hospice. So, this is something that we're dealing with, with my father-in-law. He is older. He's 91, doesn't mind me sharing information. He is in late stages of Parkinson's, has some different medical conditions. And as we navigate and manage his care, we want to ensure that he is getting the best care possible, that he's comfortable, that we're not withholding care inappropriately. And we're trying to walk this balance of at what point do you, you consider things palliative care versus hospice. So in going through this scenario ourselves with him recently being admitted to the hospital, we're really as a family kind of discussing this concept of what does it mean to be managed by palliative care versus when is it time to take that step as it were, into the hospice piece. So one thing to keep in mind is, you know, let's look at the definitions of those, but then also how that may play out in different care settings. And what I mean by that is some hospitals actually have a palliative care team that may take care of patients versus hospitalists. So remember, and I guess it's kind of a hospitalist. So if you listen to some previous episodes, I talked about what a hospitalist is and how they're the ones that manage care. When somebody gets admitted to the hospital, and they may be a regular medicine you know, hospitalist or surgical hospitalist, but same kinda concept. But there are in some hospitals but not all, a group of palliative care physicians with that. So again, let's talk about what is that and why is that really relevant? So palliative care is really specialized medical care that's focused on comfort and focused on quality of life. So it's typically, I won't just say typically, it is for patients who have a very serious illness. That could be cancer, that could be heart disease, could be a chronic condition. In our situations, our family situation, it's Parkinson's. I mean, there's something where it's something where it's a condition that is very serious, right? And there's going to be a lot of things that potentially go along with it. And so the goal with palliative care is to keep a patient comfortable, keep them pain-free, address any symptoms that they're having, any stress-related, and really just their overall well being. So a palliative care physician is going to be focused on that. And important things to keep in mind is you can get, a patient can get palliative care at any stage of their illness. It's not designed just for once it reaches a certain stage or at the end of a stage, so to speak. But really at any point, along the way, they are eligible or it's appropriate for them to get palliative care. And with palliative care, and this is an important distinction, they can be getting treatment at the same time. So a patient may be getting radiation therapy and also getting palliative, or the radiation therapy itself may be considered a palliative treatment. So palliative care doesn't mean that care is not being provided. It can be provided at the same time as a treatment is being done. And that's different than hospice, and we'll have some additional episodes where we talk in more detail about hospice. But hospice really also focuses on comfort and quality of life, but it's really designed as to focus on it at the end of life. So palliative could be at any time, support, making that patient comfortable, but hospice is designed for end of life care so that they can be as comfortable as possible. Generally, doesn't always have to stay this way, but generally, it's expected that somebody is going to be towards their end of life within the last six months. Now, that said, we had a situation with my mother-in-law. She actually was in hospice for three years, and before you say,"Well, gee, they shouldn't have put her in hospice," she was ninety-five when she passed away. And keep in mind everybody is different in how they handle certain situations. So one of the things to keep in mind with hospice is the care now has shifted from trying to do anything curative to just truly focused on the comfort for the patient. So hospice supports the patient and their family medically, emotionally, and practically with it. So what are the biggest difference? Palliative care can be alongside treatment. Hospice is comfort instead of treatment. So again, palliative, comfort alongside treatment. Hospice is comfort instead of treatment. But they both have the same focus, and that's quality of life. But again, the timing might be a little bit different. So what are some things that you might get in palliative care that you wouldn't get in hospice? The things to take in mind, you might actually get curative treatments during palliative care. You might get life-prolonging treatments. You might be dealing with different specialists as part of the process. There might continue to be diagnostic testing to make modifications to how a patient is being treated. And there might be aggressive treatments that are going on. Again, that can be very, very aligned with palliative care, where with hospice, again, it's not about treatment anymore at that point. It truly is about comfort, relieving a patient's symptoms, and supporting that patient and their family at the end of life. So, you know, when we look at where can both of these things happen, where can palliative care and hospice happen? They can happen in the hospital, they can happen in outpatient clinics, and they can happen at home. So it's not limited to one particular piece for that. So, you know, it's like with all things, you as a family member or as a patient, but really probably for most of you listening to this, you're thinking of it in terms of your family. These are hard decisions to make. And it varies on what's the best for each individual patient. So talking to your providers, talking to the appropriate people about what's the next best step for your loved one is really important. I would say, hospice is and any of you who've ever dealt with hospice know what a phenomenal, it's not just an organization, but a phenomenal way to honor a loved one's wishes and to make sure that they are comfortable is in the process. And again, making that determination of when somebody goes into hospice is sometimes a very difficult choice. Sometimes it's a very relieving choice because you know, again, you're focused on their comfort. You don't want them to be in pain. You want to make sure that you're promoting their dignity and their quality of life with that. So, other thing I'll just mention is, you know, can somebody move from palliative to hospice? Of course they can, and so it's not you only are on one pathway. Things can transition along the way. The biggest thing is to know the difference. So, as you talk to providers and as you're talking to your physicians and they start talking about palliative care versus hospice. Again, palliative care can occur at any time during a patient's life, can occur any time during a disease process. And it does occur alongside treatment, whether that's minimal treatment, really aggressive treatment. Where hospice is end of life, doesn't focus on curing anything at that point, just focuses on the patient being comfortable. So big topics, but really important ones as we navigate and we manage not just people, you know, when we talk about end of life, that can occur almost, I want to say almost at any age, unfortunately. So it's not just related to aging parents. It could be happening with a loved one who's dealing with a very serious disease. So you want to be equipped to understand the difference so that you can ask questions so that you can make the best decisions or help facilitate, someone making the best decisions. So I wish you the very best with it. I know it's challenging navigating those types of decisions. And just know, sometimes you just got to make that step forward, rely on your caregivers and your physicians. And just know that there's always a support network out there for you. So until next time, take care.