Hospice and comfort care are both types of end-of-life care, and while the terms are sometimes used interchangeably, there are some important differences between the two. Comfort care is focused on making the person as comfortable as possible, while hospice extends to provide support to the family and helping the person die peacefully. Hospice care also provides bereavement counseling for the family after the death has occurred.
Time to Live
One of the main differences between comfort care and hospice care is the expectation of how long the person will live. Comfort care is typically for people who have a relatively short time to live, while hospice is for people who are expected to die definitively within six months. This difference is important because it affects the type of care that is provided.
Care Focus
Comfort care is a subset of palliative care, which is any type of medical treatment that focuses on alleviating the symptoms of a disease rather than curing it. Comfort care is focused on providing symptom relief and making the person as comfortable as possible. The goal is to improve quality of life for as long as possible.
Hospice care also focuses on symptom relief, but lacks the long-term intent of comfort care. It is instead geared towards making the dying process as peaceful and comfortable as possible. For many patients, the side effects of curative treatments can be more distressing than the actual disease and outweigh the benefits. Patients instead elect to receive hospice care in order to avoid these side effects and have a better quality of life in their final days.
In addition to symptom relief, hospice care employs an interdisciplinary team of not only medical workers but also social workers, chaplains, and volunteers to provide physical, emotional, and spiritual support to both the patient and the family. This can be an important difference for families who are struggling to cope with the impending death of a loved one.
Location of Care
Because comfort care is delivered by a team of healthcare professionals including doctors, nurses, and aides, it requires a facility where the patient can be monitored and treated around the clock. This is typically a fully equipped medical facility such as a hospital, nursing home, or other fully staffed facility.
Almost all hospice care is provided in the patient’s home, but it can also be given in a hospice residence facility, assisted living facilities, nursing homes, hospitals, and even veterans’ facilities.
Payment Options
Comfort care may be covered by insurance, but the coverage may be limited. For example, if a patient has a terminal illness but is not expected to die within six months, their insurance may not cover the full range of comfort care services.
Insurance companies have different coverage for comfort and hospice care, with hospice care being more comprehensive and easier to obtain. Hospice care is also 100% covered by Medicare and Medicaid. In order for hospice care to be covered, the patient must first be certified as terminally ill by two physicians and elect to receive hospice care instead of curative treatment.
Palliative vs Curative Care
Comfort care is a type of palliative care, which is any treatment that is focused on relieving symptoms without curing the underlying disease. Hospice care is also considered palliative, but is unique in that it is only provided to those with a terminal diagnosis who are expected to die within six months.
Palliative care can be provided alongside curative treatments, or it can be the only type of care received. Hospice care, on the other hand, is only provided when curative treatments are no longer effective or desired by the patient.
Hospice vs Comfort Care Summary
Comfort care and hospice care both focus on relieving symptoms while maintaining quality of life, but there are some important differences between the two.
Discuss your treatment options with your primary care physician to decide if comfort care, hospice care, and a combination of treatment options is right for you.