Palliative care vs. hospice
Although hospice and end-of-life care both aim to relieve pain and symptoms in terminally ill patients, they differ in the following ways.

Both hospice and end-of-life care are important parts of palliative care that aim to relieve pain and symptoms in people with terminal illnesses. However, goals of care differ.

  • In palliative care, treatment for the person who is serious (or terminally ill) will continue.
  • A hospice exclusively provides end-of-life care to make the person comfortable and pain-free. In most cases, hospice care is the same as end-of-life care.

This decision may be taken if the adverse effects of the treatment outweigh the benefits of the care. 

Some differences between hospice and end-of-life care include:

Table. Differences between hospice and end-of-life care
Hospice care End-of-life care
Hospice care is provided to people who are in later stages of an incurable illness or nearing the end of their life such as some people with advanced or metastatic cancer. End-of-life care is provided when the person is in the last stage of any critical illness.
When no active or curative treatment is available for a critical illness, hospice care is provided. End-of-life care is given along with active curative medical treatment for the illness.
During hospice care, treatment is given to treat symptoms and negative effects. End-of-life care is given as a supportive treatment to ease the person from physical symptoms and provide emotional and spiritual support.
A hospice care team organizes most of a person’s care and communicates with their medical care team. End-of-life care can be provided by anybody such as family, friends, close associates, or care providers, but they need to communicate with the medical care team if necessary.
Life expectancy is six months or less. Life expectancy is not a factor.

What is hospice care?

When a condition, such as advanced cancer, has progressed to the point where treatment can no longer cure or control it, hospice care is used.

  • In general, hospice care should be used when a person’s life expectancy is projected to be six months or less if the illness runs its course.
  • People with advanced cancer should consult their families and physicians to determine when hospice care should begin.

According to studies, hospice care is frequently delayed. Sometimes a doctor, patient, or family member will object to hospice care because they believe it implies giving up or that there is no hope.

It is essential to understand that you can quit hospice and begin active cancer therapy at any time. However, the hope that hospice provides is for quality of life, making the most of each day while in the final stages of advanced disease.

Some doctors may not bring up hospice; the person or their family member may decide to initiate the conversation. If your therapy is no longer working and you've exhausted all other choices, you should talk to your doctor or a member of your cancer care team about hospice.

What is end-of-life care?

End-of-life care is intended for people who are believed to be in their final year of life. However, this time frame can be difficult to predict. Some people may only receive end-of-life care in the final weeks or days of their lives.

  • End-of-life care is designed to help you live as comfortably as possible in the time you have left.
  • Controlling physical symptoms and gaining emotional support for yourself, your family, and friends are all part of it.
  • You may require more of this type of care as you near the end of your life.

Conclusion-of-life care includes discussing with you, your family, and friends what to expect near the end of your life.

Individuals who care for you will talk to you about your requirements and wishes, and they will make sure that the care they offer considers what you want.

End-of-life care may include assistance with practical matters such as drafting a will or obtaining financial assistance.

What are the symptoms and care given in end-of-life care?

Although symptoms in the final stages of life differ from person to person and depend on the type of life-limiting illness, there are a few typical symptoms that people experience near the end of their lives.

It's crucial to realize that experiencing any of these symptoms does not necessarily mean that your loved one's condition is deteriorating or that death is approaching.

Table. Symptoms and end-of-life care
Symptoms Care required or advised
Unresponsiveness Some people may be unresponsive and cannot speak, but they can still hear you. Speaking to them even if you don’t get any response soothes them.
Drowsiness The person may feel drowsy most of the time, so plan good activities to do while they are alert.
Confusion Speak quietly to help the person reorient. Remind them of the time, date, and people that are with them gently.
Pain Administer pain relievers as directed. If necessary, request that the medical team adjust the medication.
Loss of appetite and reduced fluid intake Allow the person to decide when to eat or drink. If the person can swallow, give them ice chips, water, or juice as needed because these may be refreshing to them. You may keep their mouth and lips moist by using glycerin swabs and lip balm.
Loss of bowel or bladder control Maintain as much cleanliness, dryness, and comfort for your loved one as possible. Place disposable pads beneath them on the bed and remove them when they become soiled.
Skin irritation Apply lotion gently to dry skin. Learn how to safely move and modify the individual in bed to prevent the development of sores.
Sensitivity to cold and hot temperatures Pay attention to the responses of the person feeling cold or hot. Adjust the surrounding room temperature as per their need.
Breathing difficulty If the person faces difficulty breathing, rotate their body to a side and provide support with pillows beneath their head and behind their back, which may help with easy breathing. A cold mist humidifier may be beneficial.

Along with physical support, the person needs psychological support. Helping them with their emotions and consoling them are the most important things you can offer them in their end-of-life. 

  • Keep them company simply by holding their hand to reassure them that they are not alone.
  • Allow them to provide you with the information they want to discuss over a period.
  • Communicate while they fear death.
  • Hold their hand and provide support, especially while they remorse their life.
  • Agree to fulfill their wishes even after their death.
  • Surround a loved one with pictures and keepsakes, read aloud from favorite books, play music, prove long, gentle strokes, and relive life tales. All these help encourage dignity and comfort in their final moments of life.

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Medically Reviewed on 2/18/2022
References
Image Source: iStock Images

What’s the Difference Between Hospice and Palliative care? https://health.clevelandclinic.org/whats-the-difference-between-hospice-and-palliative-care/

Models of Organized End-of-Life Care: Palliative Care vs. Hospice: https://milnepublishing.geneseo.edu/nursingcare/chapter/models-of-organized-end-of-life-care-palliative-care-vs-hospice/

The Difference Between Hospice and Palliative Care: https://connect.springerpub.com/content/book/978-0-8261-3199-7/part/part01/chapter/ch01