# Palliative vs. Hospice Care: What's the Difference?

> Palliative care eases symptoms at any stage of serious illness. Hospice supports comfort in the final months. Here's how to tell them apart.

## Meta
- URL: https://aegisv2.epekdigital.com/resources/blog/palliative-and-hospice-care
- Focus keyword: palliative and hospice care
- Category: health-conditions
- Tags: depression-anxiety, alzheimers, hospice-end-of-life, emotional-wellness, nutrition, legal-planning, parkinsons
- Published: 2018-05-01

Palliative care and hospice care both prioritize comfort, dignity, and quality of life - but they are not the same service. **Palliative care** can begin at any stage of a serious illness and is delivered alongside curative treatment. **Hospice care** is a form of palliative care reserved for people whose physician has certified a life expectancy of six months or less and who are no longer pursuing a cure ([Medicare.gov](https://www.medicare.gov/coverage/hospice-care), 2024). Understanding the distinction helps your family make timely decisions instead of crisis decisions.

## What is palliative care, in plain terms?
Palliative care is specialized medical support focused on relieving the symptoms, pain, and stress of a serious illness - not on curing the disease itself. A palliative team typically includes a physician, nurse, social worker, chaplain, and pharmacist who coordinate with your parent's primary doctors ([MedlinePlus, National Library of Medicine](https://medlineplus.gov/palliativecare.html), 2024).
It is appropriate for anyone living with a chronic or life-threatening diagnosis, including cancer, heart failure, COPD, kidney disease, Parkinson's, ALS, or Alzheimer's. Roughly 1 in 9 Americans aged 65 and older lives with Alzheimer's dementia ([Alzheimer's Association](https://www.alz.org/alzheimers-dementia/facts-figures), 2024), and palliative consultations can help families manage agitation, sleep disturbance, and pain long before end-of-life care becomes the conversation.

## What is hospice care, and when does it start?
Hospice is a philosophy of care, not a place. It begins when curative treatment has stopped and the focus shifts entirely to comfort, emotional support, and dignity in the final months of life. To enroll under Medicare, two physicians must certify a prognosis of six months or less if the illness runs its expected course ([Medicare.gov](https://www.medicare.gov/coverage/hospice-care), 2024).
Hospice services include nursing visits, medications related to the terminal diagnosis, durable medical equipment, home health aides, chaplaincy, social work, volunteer companionship, and 13 months of bereavement support for the family after death ([National Institute on Aging](https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care), 2024).

## How do palliative and hospice care actually differ?
The clearest way to compare the two is side by side.
FeaturePalliative CareHospice CareWhen it startsAny stage of serious illness, including at diagnosisPrognosis of 6 months or lessCurative treatmentAllowed alongsideDiscontinued; focus is comfortEligibilityAny serious or chronic illnessTerminal diagnosis certified by 2 physiciansSettingHospital, clinic, home, senior livingHome, senior living, hospice house, hospitalMedicare coveragePartial; varies by serviceComprehensive under the Medicare Hospice BenefitTeamMD, RN, social worker, chaplain, pharmacistMD, RN, aide, chaplain, social worker, volunteers, bereavement counselor
## Where does each type of care take place?
Both palliative and hospice services are most often delivered wherever your parent already lives. That can be a private home, an assisted living apartment, a memory care neighborhood, or a skilled nursing facility. According to the National Hospice and Palliative Care Organization, the majority of hospice care in the United States is delivered in the patient's place of residence ([NHPCO Facts and Figures](https://www.nhpco.org/hospice-care-overview/hospice-facts-figures/), 2023).
If symptoms become unmanageable at home, hospice teams can transition the patient to an inpatient hospice unit or a contracted hospital bed for short-term crisis stabilization, then return them home when comfortable.

## Who qualifies, and how do you start the conversation?
For palliative care, the qualifying factor is simply a serious illness that affects quality of life - no prognosis requirement exists. For hospice, your parent's physician must document a six-month-or-less prognosis and your parent must choose to forgo curative treatment for the terminal condition.
As *Atul Gawande, MD*, surgeon and author of *Being Mortal*, has argued: families who talk about goals of care earlier - what your parent is willing to endure, what makes a day worth living - tend to suffer less and feel more at peace with the decisions that follow. His core message is that medicine's job near the end is not to extend life at any cost but to support a life that still feels like one's own.

## What does palliative and hospice care cost in 2024?
Medicare Hospice BenefitCovers nearly all hospice-related costs - nursing, medications for the terminal illness, equipment, aide visits, counseling - with little or no out-of-pocket expense for the family ([Medicare.gov](https://www.medicare.gov/coverage/hospice-care), 2024).Palliative careBilled like other specialist visits. Medicare Part B, Medicaid, and most private insurance plans cover physician and nurse consultations; medications and equipment may have copays.Room and boardNeither Medicare hospice nor most palliative benefits pay for room and board in assisted living or memory care. Families continue to pay the community's monthly rate, which averaged $5,350 per month for assisted living nationally ([Genworth Cost of Care Survey](https://www.carescout.com/cost-of-care), 2023).
## What does a real-world transition look like?
Two short scenarios illustrate the difference.
**Example 1 - Palliative care, mid-illness:** Consider an 82-year-old woman with stage III heart failure who still drives to her grandson's baseball games. She is short of breath, exhausted after meals, and anxious about her medications. A palliative consult adjusts her diuretic schedule, adds a low-dose anti-anxiety plan, and connects her with a social worker. She continues seeing her cardiologist and remains a candidate for valve repair. The point is symptom relief, not surrender.
**Example 2 - Hospice, final months:** Imagine an 88-year-old father with advanced Alzheimer's who has stopped eating, lost 14 pounds, and no longer recognizes his children. His geriatrician certifies a six-month prognosis. The family elects hospice in his memory care apartment. A nurse visits twice weekly, an aide bathes him three times a week, a chaplain sits with the family, and a volunteer reads aloud so his daughter can rest. He dies six weeks later in his own bed, with familiar staff nearby.

## How do you choose a palliative or hospice provider?
- **Ask your parent's physician for a referral** and the names of two or three agencies that serve your zip code.
- **Verify Medicare certification** on the provider through [Medicare Care Compare](https://www.medicare.gov/care-compare/).
- **Interview the agency** - ask how quickly a nurse responds after hours, who provides weekend coverage, and whether they have experience with your parent's specific diagnosis (dementia, Parkinson's, cancer).
- **Confirm coordination** with your parent's senior living community. Aegis Living's Health Services Director, for example, works directly with outside hospice and palliative teams so care plans align.
- **Ask about bereavement support** for the family - Medicare-certified hospices are required to offer it for 13 months following the death.

## How does palliative care address mood, hearing, and other quality-of-life issues?
Serious illness rarely arrives alone. Depression, anxiety, sensory loss, and cognitive change often travel with it. A palliative team can loop in geriatric psychiatry when mood symptoms interfere with treatment - see our guide to [what geriatric psychiatry adds to a care plan](/resources/blog/geriatric-psychiatry-part-of-a-comprehensive-care-plan/) - and can help families spot [signs of depression in a parent](/resources/blog/signs-of-depression-in-your-mom-or-dad/) that are easy to mistake for the illness itself.
Sensory health matters, too. Untreated hearing loss compounds isolation and confusion at end of life; reviewing the [causes and symptoms of hearing loss](/resources/blog/causes-and-symptoms-hearing-loss/) and understanding [how hearing loss affects older adults](/resources/blog/the-effects-of-hearing-loss-on-the-elderly/) can change how a hospice nurse approaches communication during a visit.

## What should families do this week?
If your parent has a serious diagnosis, ask their physician one question at the next appointment: *"Would my mom benefit from a palliative care consultation?"* It costs nothing to ask, it does not commit you to anything, and it opens a door that families often wish they had opened sooner.
If you are weighing senior living that can support a palliative or hospice partnership, [find an Aegis Living community near you](/find-a-location/) or [contact our team](/contact/) to talk with a Health Services Director about how on-site care coordinates with outside hospice providers.

## Frequently asked questions

### Can someone receive palliative care and curative treatment at the same time?
Yes. Palliative care is designed to run alongside chemotherapy, dialysis, cardiac rehab, or any other active treatment. The goal is to reduce symptoms and side effects so your parent can tolerate treatment better, not to replace it ([National Institute on Aging](https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care), 2024).

### Does electing hospice mean giving up?
No. It means shifting the goal from cure to comfort. Some patients actually live longer on hospice than expected because aggressive treatments and hospitalizations - which can be exhausting - are replaced with focused symptom care. If your parent improves, hospice can be discharged and re-elected later.

### Will Medicare pay for hospice in an assisted living or memory care community?
Medicare's Hospice Benefit covers the hospice services themselves - nursing, medications related to the terminal illness, aides, equipment, chaplaincy - regardless of where your parent lives. It does not cover room and board at the senior living community; the family continues paying the monthly rate ([Medicare.gov](https://www.medicare.gov/coverage/hospice-care), 2024).

### How long can someone stay on hospice?
The initial certification covers two 90-day periods, followed by unlimited 60-day recertifications as long as a physician confirms the prognosis remains six months or less. There is no maximum time limit if the patient continues to qualify.

### Who pays for palliative care?
Medicare Part B, Medicaid, the VA, and most commercial insurance plans cover palliative consultations and follow-up visits much like any specialist care. Copays and coverage for medications or equipment vary by plan - your palliative social worker can help verify benefits.

### Can my parent change their mind after starting hospice?
Absolutely. A patient can revoke hospice at any time and return to curative treatment, then re-elect hospice later if they wish. This is one reason families should not view hospice enrollment as a permanent decision.