What’s The Difference Between Hospice And Palliative Medicine And Palliative Care (PC)?

Hospice refers simply to ‘care of the dying’. In Europe and Great Britain (GB) it traditionally has been thought of as a ‘place’ where people could go to die peacefully; the first known one was established in France in 1842, but the beginning of modern hospice care is attributed to St. Christopher’s in London, England in 1967.

 

In the U.S. hospice is more of a philosophy and a type of care rather than a place. It has been a Medicare benefit since 1983. To be eligible, a person must be certified by two physicians (the personal doctor and the hospice medical director) that they have a terminal disease and less than six (6) months to live, assuming the disease runs its usual course. Hospice patients are encouraged to remain at home and avoid hospitalization.

 

Palliative Care refers to the care provided by a team of providers (doctors, nurses, pharmacists, social workers, chaplains, volunteers – just like in hospice) to patients whose disease is not responsive to curative treatment. The goal of PC is achievement of the best quality of life for patients and their families. It can be provided for several years and many aspects of it are also applicable earlier in the course of the illness in conjunction with anticancer treatment. [*Oxford Textbook of Palliative Medicine; the World Health Organization; or, for more information go to the Center to Advance Palliative Care website – www.capc.org]. Hospice is palliative care during the last six months of life.

Palliative Medicine, on the other hand, is the branch of medicine which studies and manages patients with active, progressive, faradvanced disease for whom the prognosis is limited and the focus of care is the quality of life. [* s/a] It has been a recognized specialty in GB since 1987 and in the USA since 2007. In reality, PC helps patients (and their families) with any lifelimiting disease live comfortably as long as possible; AND when they are at the very end of life, it helps them to die comfortably. The PC team helps preserve dignity and preserve hope while avoiding futile (nonbeneficial) care.