What Are Hospice and Palliative Care?
July 9th, 2025
Jump Ahead to:
- What Is Palliative Care?
- The Palliative Care Team
- Where Does Palliative Care Happen?
- What Is Hospice Care?
- Where is Hospice Care Provided?
- How Many Patients Receive Palliative Care and Hospice?
- Who Receives Hospice Care?
Hospice and palliative care are two similar care models that focus on alleviating suffering, managing symptoms and providing emotional and spiritual support to people living with a serious, life-limiting illness. Yet while the two models overlap considerably, there are some significant differences between the two.
What Is Palliative Care?
Palliative care is specialized care for people living with a serious illness. According to the Center to Advance Palliative Care, the goal of palliative care is to relieve the symptoms and distress caused by serious illness and to improve the quality of life of patients and their families. Unlike hospice care, which focuses on the last six months of life, palliative care can continue for as long as necessary and is often provided alongside curative care.
Many patients can benefit from palliative care, especially if it is instituted early in their disease course. It is particularly beneficial for persons living with chronic, life-limiting illnesses such as cancer, heart disease, chronic kidney disease or chronic obstructive pulmonary disease (also known as emphysema or chronic bronchitis.) The comprehensive approach offered by palliative care teams helps ensure that the physical, emotional, psychosocial and financial concerns of patients and their families are appropriately addressed, which can greatly enhance quality of life. Importantly, palliative care can be provided alongside curative care. So, for example, a person with cancer can continue chemotherapy treatments aimed at curing their disease while also receiving palliative care.
The Palliative Care Team
Palliative care is a multidisciplinary approach to managing a person’s illness. For this reason, the palliative care team typically consists of a palliative care doctor, nurses, social workers, nutritionists, physical and occupational therapists and chaplains. Depending on the individual patient’s needs, the team may provide some or all of the following:
- Treating physical pain and discomfort
- Providing physical and occupational therapy
- Offering mental health services to treat anxiety, depression and emotional distress
- Assisting with safety and mobility equipment such as wheelchairs, walkers, or a hospital bed
- Providing spiritual counseling
- Helping the patient and family identify goals of care based on their values and preferences
- Identifying financial resources as needed
Additionally, many palliative care programs offer complementary therapies such as massage, music therapy, art therapy, yoga, stress management and diagnosis-related support groups.
Where Does Palliative Care Happen?
As of this writing, most palliative care in the U.S. is provided in the hospital setting. However, some hospitals are expanding their palliative care services to include patients who are being treated in outpatient clinics while living at home. Additionally, in some rural areas not serviced by a large hospital or clinic, telehealth services have allowed greater access to palliative care.
What Is Hospice Care?
Similar to palliative care, hospice care is specialized care that focuses on alleviating suffering and improving quality of life for people living with a life-limiting illness. However, unlike palliative care, hospice is reserved for those who are expected to die from their disease within 6 months. Additionally, unlike palliative care, hospice care focuses only on comfort and symptom control, so patients must give up curative measures when they enter hospice care. They may, however, continue to take medications and receive treatment for other underlying conditions such as high blood pressure or mental health conditions such as depression and anxiety.
Hospice care can encompass many different treatment modalities. However, in general, hospice providers offer the following products and services:
- A multidisciplinary care team consisting of a hospice physician and specialist physicians as needed (for example, a pain specialist or neurologist), a registered nurse, a medical social worker, home health aides and a chaplain or spiritual advisor
- Medications to alleviate symptoms such as pain, anxiety, nausea and constipation
- Medical equipment such as a hospital bed or wheelchair and supplies like oxygen, catheters, bandages, splints, etc.
- Physical, speech, and occupational therapy as indicated
- Nutritional counseling
- Respite care to allow family caregivers to take a break
- Short-term inpatient care as needed
- Bereavement counseling
- Any other Medicare covered service that the hospice team or physician believe is necessary to maintain patient comfort, safety and quality of life
Importantly, hospice does not provide nor does hospice pay for medications and treatments aimed at curing the patient’s disease or addressing a condition not related to their terminal diagnosis. For example, if a person with end-stage cancer is receiving hospice care, his personal physician will be responsible for ordering medications that treat other unrelated conditions, such as high blood pressure or heart failure.. Additionally, the Medicare hospice benefit will not cover the cost of these medications, although Medicare Part D should.
Additionally, if a family member calls 9-1-1 or takes the patient to the emergency room without arranging it through the hospice provider, the cost of the ER visit will typically not be covered by Medicare. So it is very important that families arrange all care through their hospice nurse.
Where is Hospice Care Provided?
The vast majority of patients in hospice receive care in the home. After being evaluated by a physician and approved for hospice enrollment, a hospice nurse visits the patient and their caregivers in the home, performs an initial assessment and develops a plan of care. Depending on the severity of the patient’s symptoms, hospice staff will typically visit for about 30 minutes one to three times a week. The hospice provider also arranges for supplies necessary to meet the patient’s needs to be delivered to the home.
When a person in hospice becomes acutely ill or injured, they may be transferred to a hospital or inpatient hospice facility for some time. However, these inpatient stays are usually quite short, since the goal of hospice is to minimize invasive treatments and allow the person to die a natural death. Inpatient hospice may also be offered when family caregivers are exhausted and in need of a break from the demands of caring for a dying loved one at home. This “respite care” can be provided in an inpatient hospice or, more often, an assisted living facility or nursing home.
How Many Patients Receive Palliative Care and Hospice?
Although patients continue to have difficulty accessing palliative care in some parts of the U.S., hospice is firmly entrenched in the American health care landscape, with over 1.7 million Medicare beneficiaries under hospice care in 2021, And, according to a recent report from the National Hospice and Palliative Care Organization, the number of beneficiaries who died while receiving hospice care was nearly 50% in 2021.
With that being said, over 50% of Medicare beneficiaries receive hospice care for 17 days or fewer days, and 25% receive care for 5 days or less. Thus, while hospice utilization is definitely on the rise, many patients and families are still not receiving the full benefit of what’s available to them. The reasons for hospice underutilization are complex, and include difficulty in determining an accurate prognosis for patients with a life limiting illness, and financial penalties imposed by Medicare against hospice providers whose patients outlive their expected length of stay. In the face of both of these obstacles, doctors are reluctant to refer patients to hospice “too soon,” which causes patients to miss out on the full range of services available to them.
Who Receives Hospice Care?
According to the National Hospice and Palliative Care Organization’s 2023 report, as of 2021, two groups of patients accounted for the largest percentage of patients in hospice in the U.S. patients with cancer and those with Alzheimer’s disease and dementia (24% each) This was followed by patients living with:
- Heart disease and heart failure
- Respiratory disease
- Chronic obstructive pulmonary disease
Not surprisingly, about 75% of hospice patients are over the age of 65, and over 60% were over 85 years old.
From a demographic perspective, non-Hispanic white Americans continue to make up the vast majority (about 83%) of patients receiving hospice care. Black, Hispanic, Asian and Native American patients receive only a tiny fraction — 17.5% collectively — of all hospice services provided in the U.S. Additionally, females are slightly more likely (58% versus 42%) to be cared for in hospice than males.
Conclusion
In summary, hospice and palliative care are essential services provided to people living with serious, life-limiting illnesses and their families. Hospice care is specifically limited to those patients who have an expected life-span of six months or fewer, while palliative care is, in theory, available to anyone who has been diagnosed with a serious illness, regardless of their prognosis. However, as of this writing, palliative care is less accessible overall, especially to those who live in rural areas and certain geographic regions of the U.S.
Sources
What Are Palliative Care and Hospice Care : Active Dying. National Institute on Aging.
Frequently Asked Questions About Hospice Care. National Institute on Aging. https://www.nia.nih.gov/health/hospice-and-palliative-care/frequently-asked-questions-about-hospice-care#
Hospice Facts and Figures. National Hospice and Palliative Care Organization.
Fine, Perry G. “Hospice Underutilization in the U.S.: The Misalignment of Regulatory Policy and Clinical Reality.” Journal of Pain and Symptom Management vol. 56,5 (2018): 808-815. 10.1016/j.jpainsymman.2018.08.005