So often, in church or in conversation, I’ve heard someone say, “Hospice has been called in” about a sick or elderly friend or family member. It sounds ominous, as if the last grains of sand are slipping through the hourglass. But what does “called in” really mean?
What are palliative care and hospice care?
Caregiving can be demanding and stressful. Many Americans find themselves caring for aging parents or loved ones with serious illnesses, and there is growing attention on providing compassionate, dignified care as patients confront serious illness or approach the end of life. Palliative care and hospice programs both play a role in that effort.
Both approaches focus on comfort and support for the patient and their family, using a team-based, multidisciplinary model. The main distinction is timing and intent. Palliative care can begin at diagnosis and is provided alongside curative or life-prolonging treatment. Hospice care begins when curative treatment stops and the patient is nearing the end of life.
Palliative care
Palliative care supports people living with serious illness by easing symptoms, managing pain, and helping patients and families cope with emotional stress. Patients receiving palliative care may still be pursuing treatments aimed at cure or prolonging life, depending on their situation and goals.
The primary aim of palliative care is comfort, with therapeutic treatments included when appropriate. While some patients may recover or stabilize, many will continue to live with chronic or progressive illness. Palliative teams typically include physicians, nurses, dietitians, social workers, and chaplains. Care can be delivered in hospitals, clinics, or in the home.
Hospice care
Hospice care focuses on people in the final stages of a terminal illness when recovery is not expected. Patients who enter hospice usually have a prognosis of months rather than years and have chosen to stop curative or life-prolonging treatments. The goal of hospice is not cure but to maximize comfort, maintain dignity, and improve quality of life in the remaining time.
Hospice services are provided by a multidisciplinary team that may include physicians, nurses, social workers, grief counselors, chaplains, and volunteers. Care can take place at home or in a healthcare facility; some hospitals and organizations maintain short-term inpatient hospice units for symptom management or caregiver respite.
Medicare Part A covers hospice and palliative care in many cases. Medicaid covers hospice in some states, and private insurers often include hospice benefits. Some providers also offer care regardless of a patient’s ability to pay.
Hospice misconceptions
There are several common misconceptions about hospice. It is not only for the elderly: hospice is available to anyone nearing the end of life, regardless of age. It’s also not limited to cancer patients. While many hospice recipients have cancer, hospice serves people with a wide range of terminal conditions, including Alzheimer’s disease, heart and liver disease, ALS, stroke, and those reaching the natural end of life from other causes.
A changing mindset that warrants new nomenclature
Saying “Hospice has been called in” emphasizes that recovery is no longer expected, but that phrasing can sound bleak. Perhaps we need language that reflects what hospice teams actually do: help people live well, all the way to the end. Good hospice care aims to make the final phase of life as meaningful and comfortable as possible, reduce suffering, and preserve dignity. Providing physical comfort and emotional and spiritual support to patients and their families is, ultimately, a profound act of compassion in end-of-life care.