The Difference between Hospice Care and Palliative Care 

My dear friend just passed away from stage 4 metastatic ovarian cancer. She did chemo for months before it was made clear to her that her chemo was palliative, meaning it would keep the cancer from growing any further for a while but would not reverse the cancer. She never understood what was happening until we attended doctor visits with her and made sure it was explained to her plainly. She finally stopped the chemo because her quality of life was terrible. It broke my heart that she suffered through all that chemo thinking it would shrink the cancer and “cure” her.

While still in the hospital, my Dr told me I needed to be on palliative care. My team was awesome. They made the difference to even to continue trying. My palliative care lasted for 10 months. Yet, to get back to some normalcy took just over two years. My hubby (medical professional) & friends were like coaches. They also made sure to get me to every doctor appointment & every physical therapy appointment. My hubby even did my hair & helped dress me. He 'awed' me ❤❤❤

Thank you for what you do! My grandma’s hospice nurse was named Julz. She SAVED me! I had lost my mom in 99 and my grandma and I were super close. I took care of her for 6 years before she died and was her medical power of attorney. I had to make decisions by myself except for her angel hospice nurse!

I wish I had been told about palliative care vs. hospice when trying to help my 89 y.o. mother with her alzheimers. I was so relieved when her neurologist office set us up with a patient care support person, then was very let down when that person never returned my calls when I asked for guidance about my Mom's care. Mom fell in her bedroom at my home, broke four ribs, and after 12 hrs in the ER she finally got a room. By that time, she had started to get very restless and agitated. She failed a swallowing test and had been apirating food and drink for a time (I thought her weak coughing was because the air was dry, so I set up a humidifier in her room). Even the hospital hospice folks I talked to weren't sure if she needed hospice. So, she was NPO, but staff felt that she was too responsive for home hospice care. Three days later, and after demanding to talk to an actual doctor, I got her home, with oxygen and a bed via hospice. The first hospice nurse we had to do her intake said she could last for months (really, I thought. She can't really eat much) and I was told to buy prune juice and ensures. The next day, a wonderful older hospice nurse came and did a proper evaluation on mom. We didn't have long. Finally, we got the guidance we needed, but I wished it had been much sooner. My Mom came home on a Thursday, and by Saturday afternoon, she was gone. The confusion of care in her final week and the abandonement we felt from her neurologists office has left me afraid to get old and sick. Our healthcare system in America has dried up and blown away. Where was the communication, the guidance, and the support I had stupidly expected? We had a wonderful experience with hospice ten years previous when my mother-in-law died of lung cancer. I went into caring for my Mom, expecting the same experience. Something needs to be done.

Mom passed away couple months ago. Mom had an undiagnosed dementia condition that for some reason all her doctors evaded to discuss with us. Along with her six other diagnoses, her symptoms were not clearly recognized by family, only assumed. Wished I had known more about palliative care rather than relying on doctors to bring it to our attention. It would have helped us as caregivers to become more educated in the changes we were observing and to take the verbal and behavioral changes, less personal. Because I didn’t understand the behaviors, I misunderstood or misinterpreted the symptoms. Please everyone, once there is a diagnosis for anything, ask the doctor to explain palliative care and to initiate the process. Don’t wait for the doctor to bring it up with you. We didn’t get the assistance of palliative and headed straight into hospice.

Thank you, Nurse Julie. My mother was fully independent just last month. No meds, no diagnosis, etc. She went into the hospital after altered mental state one day and we found out that she has heart failure in its end stages. We decided to put her on hospice rather than opt for palliative care because the doctor explained that the treatments were just prolonging and causing more pain. Unfortunately, since she came home recently, I've watched a steady decline, but your videos have helped both of us understand the process more and feel more at peace with her end coming soon. Your video about morphine helped her understand that it's okay to take and she can at least enjoy a few hours each day with her grandchildren.

My MIL passed while on palliative care for a major stroke. She had a partial stroke that just left her a bit confused on a timeline. Then while in hospital she had a full stroke but recovered somewhat but she refused to eat. Then she had another stroke and was unconscious. I think they did pallative care because they knew we weren't equipped to be able to care for her at home. She lasted a week with many this is it calls during this week. She waited till we all said we loved her. We went outside for a smoke and came back in and she was taking her last breathes..she went peacefully with no pain. They just gave her iv ativan to calm her when she got agitated. They took wonderful care of her making sure she was clean and comfortable. She died with us holding her hands. Very peacefull.

Lady full of Sweetness and clarity. Thank you

Thank you for this Julie. This really helps me. My mom is 91 and has now moved in with me. She can’t care for herself as she’s beginning stage dementia. She had a mild stroke in January which kind of sped things up a bit. She has chronic kidney disease and struggles with severe right flank pain. She has been receiving home health care but the nurse now thinks she needs to move into palliative care. I asked if that was the same as hospice and she said no and that mom doesn’t need hospice at this point. She tried to explain it to me but your explanation makes much more sense. I’m so appreciative of you.

I’m a Palliative Care Social Worker and you explained these 2 services almost exactly the way I do! I wish everyone living with a serious illness knew they could have Palliative Care while also getting curative treatment.

Hospice Nurse Julie, I have a debt of gratitude to you. Your videos were so helpful as my mother laid dying. It was an extended painful experience for my brothers and me. Your videos gave me comfort and perspective. You are a very special and unique person. Thank you so much for your informative and helpful videos.

So, I have a close acquaintance (my ex-wife's husband and "step" dad to my daughter, although not adopted), newly diagnosed with stage-two pancreatic cancer. He already has a weak heart, the concern for the last few years was: when would his heart give out? I saw him yesterday, he doesn't look good (very thin, gaunt eyes with jaundice). It seems he will be facing some very difficult times ahead, (he is already on some kind of strong meds before this for various reasons). I just wanted to say, after watching just one video that you are a very special breed of people. I hope your day is going well.

Thanks for this clarification. I thought that they were the same thing.

Nurse Julie, you are a true GIFT to the sick & people who love & care for them! GRATITUDE!!!!!

I would only submit to PAIN medications and no further treatments if given a terminal diagnosis. The thing I don't understand is when people choose to spend their last dime and undergo endless suffering to *STAY OUT OF HEAVEN* especially those who believe in an afterlife. I personally would want to reunite with deceased loved ones, friends and meet the main man *JESUS* asap!

THANK YOU. I've been watching for a while, to understand for a family member locally. Now, I have a family member elsewhere here in Australia who suddenly needs much deeper care, probably palliative care. Your video series has been shared with the family. SAME, ONLY DIFFERENT, of course. Again, THANK YOU.

Hi Julie , my father died last week in a nursing home , your videos really helped me understand the actively dying process which meant I could explain it to my Mum . Thank you for that . Sue from the UK x

My brother is getting hospice palliative care in California. Hopefully we have many years left with him.

You explained the way my ongoing palliative care experience and treatment is as I see it! I am proud of each specialist and their staff, each and every nurse at every level, everyone together is making a great team! But none of this has happened quick, this has taken a few years with constant changes and setbacks, so one should not expect a long term easy path as in my situation with Parkinsonism and other issues. From what I am reading in the comments some are lost in the maze of the healthcare path, it really is difficult to navigate and deal with! I feel for everyone here following you, and I am so grateful that you are doing this! Every little bit of encouragement helps everyone, and if I can help someone in any way with a question, I will be happy to do so!

Hi julie just recently stumbled across this channel, due to my late grandfather who has sadly lost his life over the weekend due to heart and lung capacity issues due to life long cigarette smoking, he was in palliative care last few weeks of his life but what what hit home was when nurses said week leading upto his death is if he has an heart attack would we want to resuscitate him and they are stoping treatment 😢, seeing how he was before his decline in health he was quite well built to when he was a few week to end of his life he dropped alot of weight looked proper weak, struggled majorly to be mobile and all the signs you have said about what they go through at the end of the life like talking to deceased ones like his brother and also he said "make them go away from my house,they will rob it" 😂 whilst me my mum and immediate family was in the house, plus a funny quote he said he wanted a "cuppa with a flower in it" since im from the uk cuppa is a slang for a hot beverage called tea bless him but apparently before death he reached out with his arms in the dying moments 😢 least he is reunited with his wife also my nanan... sorry for rambling on and on i was in tears writing this R.I.P grandad you can finally rest ❤

Thanks for the info, Julie. You have taught us all a lot.

Thank you Julie, you are a gift.

Thank you so much for sharing this information! I wish I knew this a few years ago while my mom was struggling with her disease. Doctors did a TERRIBLE job explaining the differences between the two. It made making the decision very hard and we honestly started Palliative way too late. With this awareness I might have asked different questions that could have led to a more peaceful decision.

Thank you. This is an excellent video that clearly explains the subject. As an ICU nurse this video was very helpful to me and now I will be able to explain to patients and their families the similarities and differences between Hospice and Palliative care.

Thank you nurse Julie. I am in paliative are in UK and the system here is similer except the hospital are is free (NHS) but hospice and paliative care is only partly funded, the rest is charitable giving. I was recommended for paliative careby my Oncologist when I was diagnosed with cancer for the third time and with a heart problem. After being shocked at the thought of a limited life expectancy I learned that a) end of life care was only 5% of their work and b) they were a great bunch of people who are making my life and safety better and care is there when I need it. Don't be afraid of accepting paliative care when it is offered.

Thank you for your excellent explanation 👍 👏

Very good information. Thank you.

This is an excellent video! In my CPE (clinical pastoral education; which is to say, chaplain) training class, these terms come up A LOT! Thank you :)

Australia has a different funding model so the term "hospice" doesn't have the specific meaning that it does in the USA. Palliative care is the umbrella term for most end-of-life and symptom control care.

You did an excellent job of explaining the differences. Thank you.

Thank you for all you do 🌹🌹🌹🌹🌹🌹🌹🌹🌹🌹🌹

Thank you for being so organized in your delivery. Super good video. It isnt something I need right now but in future u need to know diffrence 🤘🏻😎💛🧡❤

Thanks

The one thing im scared of is not the death but I know this is weird but im worried about how I will look and what happens to the body afterwards

Happy Easter Julie

Hi! /@hospicenursejulie Thank you so much for this timely video. My dad was diagnosed with ALS back in Nov 2023 but has had symptoms for a while now. It was hard for primary doc to diagnose- he presented well and all blood work etc normal. They missed reviewing ADLs / iADLs-…so I sent a checklist with his answers to demonstrate something was off. Long story short- he was just discharged from the hospital and now is eligible for hospice -- we are considering palliative care at this time since he may need the SLP for assistive technology in order to learn how to communicate wants/needs before we switch over to hospice. Thank you for clarifying that they are both different terms. Is there more information regarding palliative care that would be helpful for anyone dealing with ALS? Thank you in advance for your time. 💕

I was a caregiver for a 93 year old woman who was in hospice for dementia, asked about a striker bed, a month later she fell out of bed and fractured 2 disks.....I was angry at hospice, they didn't take me seriously ...now she's in a nursing home....

i think you are great! what you offer and how you communicate it all is such a help. but i think you missed an important point in this video: explaining that someone with a chronic illness can choose palliative care to manage symptoms AND give up on medical intervention for the underlying cause. palliative care does not necessarily include medical intervention, which is why hospice is palliative care for end-of-life. i think how it gets paid for (though of financial importance) is not as key an element as you make it for understanding the difference between hospice and palliative care.

Hi Julie. I love your videos as I take care of my Mom in my home and she has a ton of health issues. It helps me a lot. I never know what I will find when I get up in the morning. My question, and maybe I need to go back and watch a couple of your explanations, But, you say that hospice is for terminal and at the end of life and less than 6 months to live but previous videos have said you can come off hospice and be fine for a while. Mom is not on hospice and has quite a few health problems. We are not at that point yet, but even with her stubbornness, I can see it coming in the future. It is just taking care of her and I work full time. Do I need to at least look and investigate hospice just in case? Thank you and keep doing what you are doing.

Have you seen some of the same symptoms in dying animals as in humans? For example, my elderly weechon will stand on my bed and bark at nothing for hours, and it seems like people having conversations with people who aren't there.

My mother in law was on hospice for 2 yrs

How is palliative care paid for? (I have Medicare, and stage 4 breast cancer that seems to be stable for now.) Are there palliative care doctors? Do you give up your medical oncologist if you choose palliative care? I'm for having all the support I can get. How do I find palliative care?

My son is in medical school and did some rounds with a Palliative Care doctor and was moved. He felt blessed to be alive and is now interested in it as a future. Your thoughts would be greatly appreciated on the field as a future in medicine, specifically as a doctor?

Criterion-singular Criteria-plural

To me, hospice means that you are living with a life limiting disease. You come to a Palliative unit for symptom management and/or pain control. You may be discharged to home or to a Hospice Facility. Hospice care means that you have reached the end of treatment options for the life limiting illness, and you are dying from the disease. Is that correct? Thank You Julie 😊

Thank you for all of your informative videos ! My Mom was on Hospice a week before she passed away…..the Hospice facility was amazing along with all the nurses…❤️

I have stage 4 NASH with cirrhosis, I am still confused about this. I want to die in my bed at home, how can this be done in the US? I live in the bay area but my LFT's have improved despite still being considered end stage and I have to test the MELDna 3.0 protocol every 12 weeks. I was told I had hours to live back in November after a severe GI bleed. I won't ever get "better" I just hope to remain the same for 10 years (unlikely I know), my docs all say my lack of support in the family area etc..puts me off the transplant wait list as well as my Lupus and anxiety disorder...wouldn't anyone dying at 44 with a 20 year old who will be ALONE in the world when I die make anyone anxious?! End rant. Thanks for the info! I just want to be at home and not anxious or in pain.

Canada vs. USA palliative vs. hospice systems are totally different for those viewing in Canada... So check your provincial/territory health websitef or Canadian info

Hi nurse Julie. If someone has been on palliative care for a year or so....can at some point it be changed from palliative to hospice? Thanks.

By these definitions, the MD who pronounced my wife's pancreatic cancer to be not only incurable (which we all knew), but not even worth treating, was confused between "palliative" and "hospice" care. He said she would be sent home for "palliative care." But once she was home, she immediately started hospice care. "Palliative" consisted of morphine. Essentially -- she was sent home to die.

It's very hard to have a family member in palliative care, my mother took care of my sister who had amyotrophic sclerosis for 3 years, i helped all this while, she passed away last November, we didn't have any doctor or nurse because it's not provided in my country and we couldn't afford to pay for one.

Who could address a hospice eligible cancer patient’s explosive anger, every other day or so, toward a family caregiver? He thinks he is never wrong; he “tried” psychiatric treatment for ~2 weeks and declared it useless; he alienated the rest of his family years ago; and he still drives though he is on 2 very strong pain meds. So what advice would you give his caregiver? I know she needs to leave immediately, but any other ideas?

Palliative Care as you described is still very vague.

It was all in home , out of pocket pay. Took all her soc sec check and alot of our personal funds. Approx $20.00 per hour. No care but home self care from 5pm to 9am

My friend has progressive MS and she is in a wheelchair but has a walker. She has hospice but she says shes not dieing that hospice sends nurses to her home! Is she dieing but dont know? The doctor said shes had this like 18 yrs she cant walk falls constantly!

We had a gentleman at our church go on Hospice. One Sunday he walked back into church claiming he got off of DYFS. We all laughed about it. Within a year he did pass away. Can someone recover from Hospice or was he miss diagnosed?

Does insurance cover palliative care?

❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤

I recently asked my doctor if she would refer me to palliative care. I did it over my chart and I’ve not heard a word back….

Very Interesting I attempted to discuss palliative care with my oncologist.... very dismissive... I have stage 2 prostate cancer with multiple related issues..multiple cardiac issues...and a whole myriad of chronic conditions...way too much for 1 person to manage solo

You seem to focus only on home hospice-can you address hospital hospice?

Hi Julie, you know what really really upsets me is that people like me who are suffering from not only agonizing pain and other chronic illnesses but also mental illnesses such as COMPLEX PTSD AND I'LL SAY FOR ME THAT IS EXTREMELY DEBILITATING I CRY ALL THE TIME I HAVE MELTDOWNS IT'S HORRIFIC WHY DO THEY NEVER ADDRESS MENTAL ILLNESS? PLEASE ANSWER I REALLY WANT TO KNOW THANK YOU.

If you go in palliative care, can you at some point later switch over to hospice care ?

If you are your loved one is in the VA system, don't look for any help either in palliative or respite care. And will add that differs from agency to agency. The question to our VAMC was do you offer respite care for a 100% disabled vet who has a life limiting diagnosis. Answer - yes we do.. Question - when can we set it up for a week or so. Answer - Oh we don't do it that way. Question- then how do you do it? Answer - we don't offer it cause we have no beds for that. Question - then you don't off respite. Answer - of yes we do. That's when I realized that even though my vet was dying from combat related disease --I wouldn't get any help from the VA.

In Australia Palliative care means pain management so you don’t have to be dying to be palliated here!

Dr Bryan Ardis said when you hear "palliative care" in a hospital, he said that's a death sentence should the family hear that spoken to them. His father in law died from remdesivir. This was during the forced intubations and the kidney destroying remdesivir cheeny virus days. He showed from studies the degree of kidney damage after use of remdesivir ... that's what he said.