UNC Health Talk

Understand the Difference Between Palliative Care and Hospice Care

People experiencing a serious illness—whether their own or a loved one’s—are faced with many emotions and important decisions. One of these decisions might be whether to pursue palliative care or hospice care; these two types of care are sometimes confused.

Gary Winzelberg, MD, MPH, associate medical director of UNC Health’s Palliative Care Program and director of the Hospice and Palliative Medicine Fellowship Program, explains the two services and how understanding their differences can help patients and families make informed decisions.

What Is Palliative Care?

Palliative care is specialized medical care that focuses on helping patients feel better by providing relief from their symptoms as well as from the pain and stress of a serious illness. It involves a team of health professionals who seek to promote the person’s quality of life, no matter what stage in their illness.

Individuals receive palliative care at the same time as treatments meant to cure or treat the disease. Palliative care serves patients with serious illnesses, including cancer, dementia, congestive heart failure, lung diseases and chronic kidney disease, independent of their prognoses—meaning whether their disease is terminal or they are expected to live for years with treatment. Receiving palliative care has been demonstrated in multiple research studies to improve patients’ quality of life, particularly when started soon after diagnosis.

“We see patients who need help in managing the physical, emotional and spiritual effects of any life-altering condition,” Dr. Winzelberg says.

Palliative care includes advocacy, he says.

“We are dedicated to making sure the goals that patients have related to their care are known, and we help make sure their values and priorities are understood through communication with their care teams and completion of advance directives,” Dr. Winzelberg says. That’s why the palliative care team includes doctors, nurses, social workers and chaplains who complement the work of a patient’s primary doctor as an added layer of support.

Within UNC Health, access to palliative care is available in the following areas:

  • Inpatient adult palliative care
  • Outpatient palliative care
  • Community-based palliative care
  • Pediatric palliative care

What Is Hospice Care?

Hospice care is also focused on relieving symptoms and pain, but it begins after treatments to try to cure or control the disease have stopped.

“When a person’s illness worsens despite multiple treatments or their disease management causes more side effects than benefits in terms of quality of life, then that’s when we start considering whether hospice can help promote a person’s comfort and dignity while also supporting their family,” Dr. Winzelberg says.

It’s a different philosophy of care, he says, than what a patient has been receiving. It’s not about giving up hope, but choosing to prioritize comfort so that each day can be the best day possible.

Typically, hospice is provided for a person with a terminal illness whose medical clinician believes he or she has six months or less to live if the illness runs its natural course. Occasionally, people may receive hospice care for longer than six months, Dr. Winzelberg says.

Hospice care can take place at a patient’s home or in a care facility, and it’s available no matter the patient’s age. Like palliative care, the patient receives services from a team of health professionals, including nurses, social workers, chaplains and doctors, as well as volunteers.

“It’s important to have that support toward the end of their life to focus on what matters most to them,” Dr. Winzelberg says.

UNC Hospice provides care to patients in Alamance, Chatham, Durham, Lee, Orange and Wake counties. When care in the home is not possible, UNC offers care through the SECU Jim and Betsy Bryan Hospice Home in Pittsboro.

Deciding Between Palliative Care and Hospice Care

Both palliative care and hospice care seek to empower patients and their families at a very difficult time.

“People feel like they are being heard when it comes to the stresses that they have and find support in coping with their illnesses. While receiving specialized symptom management, patients can learn about options for care so they can make the best decisions for themselves,” Dr. Winzelberg says.


If you would like to learn more about hospice or palliative care, talk with your doctor. Need a doctor? Find one near you.