The Common Sense Guide to Improving Palliative Care > 1.7 What Is Palliative Care? Why Is It Not Hospice?

Sick To Death book cover This extract from the online edition of The Common Sense Guide to Improving Palliative Care is used with permission.

What Is Palliative Care? Why Is It Not Hospice?

Throughout this manual, we will talk about palliative care, a term with many official definitions and sometimes confusing meanings. We generally use the definition from the World Health Organization, which calls it "the active total care of patients whose disease is not responsive to curative treatment . . . [when] control of pain, of other symptoms, and of psychological, social, and spiritual problems is paramount" (WHO, 1990). People who receive palliative care may receive disease-modifying and comfort measures simultaneously, and they may require such care for years.

Hospice, however, is the term used to describe an array of services provided to patients close to dying. In the United States, hospice tends to be defined by the Medicare hospice benefit, which requires that the patient's prognosis is to live six months or less. This prognostic requirement often prevents hospice providers from caring for stable patients with advanced illnesses such as heart and lung failure, dementia, or frailty, which can have persistently uncertain prognoses. Palliative care usually serves a broader period of time.