The Intersections Between Hospice and Palliative Care

Hospice care and palliative care services have similar, but diverging, threads across the care continuum. 

An area of increasing overlap centers around patient consultations discussing symptom management and goals of care.

Supportive care for patients and families is a common thread in both hospice and palliative care, with providers touching different points along a patients’ disease trajectory, according to Brynn Bowman, CEO of the Center to Advance Palliative Care (CAPC). The organization recently held a conference with the Coalition to Transform Advanced Care (C-TAC).

Palliative care and hospice share some common goals with hospice. Both aim to manage pain and symptoms for patients in critical health stages, she said. Ensuring that patients receive the right form of care at the right time is crucial Bowman indicated.

“Many leaders in the hospice and palliative care fields want the same thing for patients in that philosophical approach to care,” Bowman told Hospice News during the C-TAC-CAPC Leadership Summit in Washington, D.C. “The question is, how do we appropriately make sure that as soon as a person needs supportive palliative services, that they have the right access at the right time and the transition to hospice as it continues to evolve is appropriate.”

Hospices have increasingly built out palliative care as an additional business line, a trend that continues to accelerate.

More than half (56%) of hospice care professionals indicated that their organizations planned to launch palliative care programs during 2023 in this year’s Hospice News Industry Outlook Survey, prepared in collaboration with Homecare Homebase. This is up from last year’s results in which 52% of respondents reported the same. Survey respondents included nearly 330 hospice and palliative care industry professionals, including owners, executive leaders and managers, among others

Hospices seeking to reach patients further upstream could benefit from integrating a palliative consultative model into their works, according to Allison Silvers, chief health care transformation officer at CAPC.

“Hospice is a model with a definition of what gets delivered, how often and by whom,” Silvers told Hospice News at the summit. “One opportunity that could be better utilized is a consultative model, but it is a divergence for a consult. Hospice is a symptoms management model, but there’s also a delineating line there, particularly in the requirement to give up curative treatment. And that doesn’t fit a lot of patients and families’ beliefs. There’s opportunities to get rid of the ‘giving up’ component in palliative care where patients can be much better served.”

A headwind hospices often face in their growing palliative lines is a lack of awareness around the nature of these services among the general public and health professionals alike. Common issues are that medical and nursing students do not receive enough exposure to palliative care throughout their training, while patients, families and clinicians often conflate these services with hospice.

More research and education are needed to help fill these knowledge gaps and improve understanding of both hospice and palliative care and how they differ, said Dr. Andy Esch, palliative care specialist and CAPC’s senior education advisor.

Better understanding could foster improved care coordination between hospice and palliative care, helping providers to address unmet patient needs, he stated.

“Through education, awareness and research, we need to make it automatic for anybody interfacing with a patient to recognize suffering or an unmet need and figure out where to refer them and think about giving them palliative care,” Esch said at the summit. “The job is always making sure patients get the right services they need, and when someone is eligible for hospice, there’s a benefit in that program. And if they don’t qualify, they still deserve to have their symptoms managed, their care coordinated and their spiritual and psychological needs met. We need to make people more aware, and we need research to support the outcomes before it becomes more automatic.”