Hospice vs. Palliative care: What's the difference?
11/21/2022 by Andy Bock, D.O.
Your mother has just been diagnosed with lung cancer. The cancer has spread to other parts of the body. She is not sure she wants to go through chemotherapy. Now what?
The first step is having a discussion with your mother's medical care team. There are options available to provide the best quality of life for patients with a serious illness.
Hospice care
Hospice care provides symptoms management and some nursing care for patients with terminal illnesses. Hospice care is designed to help patients live as well as possible by aggressively treating their symptoms and attending to their quality of life.
Palliative care
This medical specialty is also designed to help patients live as well as possible by partnering with the patient's care teams to focus on the management of symptoms as they undergo disease-directed therapy, such as chemotherapy, dialysis or hospitalization for heart failure.
But how do you choose?
This decision is best made by working with the patient's primary care clinician.
If the patient prefers to focus on comfort and quality of life, they may be referred to hospice. The hospice team will provide visits from a nurse, chaplain, social worker and home health aide as needed. In addition, the hospice agency will provide durable goods like a hospital bed and medications to provide comfort. The hospice team will work closely with family and friends to provide hands-on care that is needed for the patient. Not all patients qualify for hospice.
If the patient wishes to continue disease-directed therapies, they may be referred to a palliative medicine specialist for advanced symptom management. Palliative care is often provided in an outpatient clinic, much like seeing your primary care clinician. Palliative care specialists also see patients in the hospital, nursing home or their homes. The focus of care is to assist with complex medical decision making and management of symptoms such as pain, nausea, shortness of breath, fatigue, spiritual distress and mood changes. The palliative care specialist will provide prescriptions for medication to help control symptoms. They can also assist with the decision to transition to hospice care.
If you or your family need help deciding on the best course for are, be sure to discuss the situation with your primary care clinician.
Andy Bock, D.O., is a physician in the Division of Community Internal Medicine, Geriatrics and Palliative Care, Section of Palliative Medicine. He is board certified in Hospice and Palliative Medicine and is the Mayo Clinic — Hospice medical director. His interests include improving physician communication and complex medical decision making, including advanced care planning and end-of-life shared decision making.