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5 case studies: When is it time for palliative care versus hospice?

Never hesitate to say “I need help” if you’re struggling to cope with the pain and distress of a life-limiting illness. Hospice and palliative care providers are specially trained to hear your plea and will offer comfort, compassion and support.

“Just because you ask to speak with a palliative care or hospice care provider doesn’t mean you have to start service,” says Lisa Wasson, RN, clinical educator for HopeHealth.

Palliative care and hospice care are two different sets of services, although you might hear people use the terms interchangeably.

  • Palliative care is for patients with a serious illness who are still receiving curative treatments, such as chemotherapy or dialysis. Palliative care providers offer medical relief from the symptoms or stress caused by either the illness itself or the treatment. They also help patients understand their options and establish goals of care.
  • Hospice care is for patients with a life-limiting illness who have decided to stop curative treatments or have been given no further treatment options for cure or to prolong life. A full team of doctors, nurses, social workers, spiritual chaplains, hospice aides, grief support professionals and volunteers offer comfort and support to the patient and family.

To learn more about these differences, read The ABC’s of curative, palliative and hospice care.

5 case studies: Is palliative care or hospice care more appropriate?

Below are five fictional stories to give you a sense of when it could be helpful to ask for a palliative care or hospice care consultation. (Every medical case is unique, and only your health care provider can advise on your care.)

Case 1: An 86-year-old with Alzheimer’s disease is repeatedly hospitalized

Janet was diagnosed with Alzheimer’s disease nine years ago and lives at home in the care of her husband. She cannot make her needs known, is incontinent and depends on her husband to feed her. She has lost 20 pounds in six months and been hospitalized three times.

Palliative care or hospice? Janet would likely qualify for hospice care given how far along her disease has advanced.

Case 2: A man wishes to stop dialysis despite family’s wishes

Robert is 64 years old and has kidney failure, coronary artery disease and diabetes. He receives dialysis three times per week but wants to stop treatment. Today he was hospitalized after skipping two dialysis appointments. Robert’s family is concerned he is giving up, and they don’t know what to do.

Palliative care or hospice? Robert and his family need to get on the same page regarding his options and wishes. A good first step would be to ask a palliative care provider to guide that conversation with skill and sensitivity. Ultimately, Robert does have to the right to stop dialysis and choose hospice if he wishes.

“We deserve as much beauty, care and respect from the health care system at the end of life as we receive at the beginning when we are born” —Lisa Wasson, RN, CHPN

Case 3: A 30-year-old with breast cancer and her mother need support

Imani has undergone two rounds of chemotherapy and radiation for breast cancer. She has severe nausea and is losing weight due to poor appetite. Her mother, who works full time, is her primary caregiver.

Palliative care or hospice? Imani is actively fighting her disease with curative treatment and might qualify for palliative care. She would receive symptom management, support services to help her mother, and a conversation about her goals of care.

Case 4: A woman with autoimmune disorders battles depression

Cindy, age 52, has multiple autoimmune disorders, fibromyalgia pain and depression. She takes antidepressant medication, is self-isolating and cannot hold a job due to taking too many sick days.

Palliative care or hospice? Cindy is not a candidate for either palliative care or hospice care because she does not have a life-limiting disease. She still needs support, though, and would be referred to a case manager or social worker.

Case 5: A man with advanced ALS requests a do-not-resuscitate order

Carter has ALS, or amyotrophic lateral sclerosis, a progressive neurodegenerative disease. He has been hospitalized with infection five times and is on a ventilator. Carter is alert and told doctors he wants to return home and sign a do-not-resuscitate order (DNR). His family is upset about his decision.

Palliative care or hospice? While in the hospital, Carter can request to speak with a palliative care or hospice care provider to guide this sensitive conversation with his family. If he wishes to start hospice, a team will help him return home, tend to life-closure tasks and die in peace and comfort surrounded by his family.

Lisa Wasson hopes more patients and their families will seek to understand the benefits of hospice and palliative care. “We deserve as much beauty, care and respect from the health care system at the end of life as we receive at the beginning when we are born,” she says.

Questions about hospice care or palliative care? Contact us at (844) 671-HOPE or

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