Columbia Senior AdvisorWhat is the difference between hospice and palliative care?
Palliative care relieves symptoms and stress at any stage of a serious illness, alongside treatment aimed at a cure; hospice is comfort care for someone whose physician certifies a life expectancy of six months or less who has chosen to stop curative treatment for that illness.
Palliative care is often provided by a hospital or clinic team; hospice is provided by a licensed hospice program that brings nurses, aides, a social worker, a chaplain and volunteers to wherever the patient lives. DPH's data shows 18 licensed hospice programs with Midlands offices and 1 inpatient hospice house: Lexington Community Hospice House (Lexington, 30 beds).
Who pays for each?
Medicare's hospice benefit covers the hospice team, medications and equipment for the terminal illness with little or no cost to the patient; palliative care is billed like other medical visits under Medicare Part B or insurance, with the usual copays.
Neither pays room and board in a CRCF or nursing home. Medicaid and most private insurance also cover hospice.
Can hospice care happen in a Columbia assisted living facility?
Yes. Regulation 60-84 lets a CRCF bring in a licensed hospice under a physician's order, so many residents receive hospice in their own room rather than moving; nursing home residents can receive hospice too.
When symptoms cannot be managed where the patient lives, short inpatient stays are available, and the Midlands' licensed inpatient hospice house is in Lexington. Ask any hospice how quickly a nurse comes at night and who covers weekends.
When should we ask about hospice or palliative care?
Ask about palliative care as soon as a serious illness is diagnosed, and about hospice when treatment stops helping, hospital trips become frequent, or your parent says they want comfort rather than more treatment; an informational visit commits no one.
Hospice works best over weeks or months, not days, and families often say afterward they wish they had called sooner. A family can call a licensed hospice directly to ask questions before a physician's referral.
Can a patient move from palliative care to hospice, or leave hospice?
Yes to both: many patients begin with palliative care during treatment and enroll in hospice later, and a hospice patient may leave at any time to resume curative treatment, then return to hospice if eligible.
Hospice eligibility is recertified in benefit periods, and some patients improve enough to be discharged. Neither choice is permanent, which takes some of the pressure off the first conversation.
Side by side
| Hospice | Palliative care | |
|---|---|---|
| Timing | Life expectancy of six months or less | Any stage of serious illness |
| Treatment | Comfort care instead of curative treatment | Alongside curative treatment |
| Payer | Medicare hospice benefit | Medicare Part B or insurance, with copays |
| Where | Home, CRCF, nursing home or hospice house | Clinic, hospital or home visits |
Drawn from S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS publications, CareScout, CMS, the VA and the regional aging agencies cited in the text; our editorial standards explain how we check them.
