End-of-life care vs Palliative care

A comparison of end of life care and palliative care

When someone is living with a serious or life-threatening illness, conversations around palliative care and potentially end-of-life care may become more important, but it can be difficult to understand what each type of care can do. If you have questions about what palliative care is, what end-of-life care is, who each type of care is for, and the key differences between them, we are answering all of your questions here so you feel more confident in your knowledge and decisions. We will also take a look at who helps manage each type of care, and when it may be time to move from palliative to end-of-life care. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global home care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about palliative care or end-of-life care, we can help. 

What is palliative care?

Palliative care is a different type of care, and although it can be used as a part of end-of-life care, it can also be relevant for someone living with a serious illness that is causing them significant pain, but will not necessarily lead to their passing.

This type of care aims to alleviate any symptoms, pain and stress the person may be experiencing in an effort to improve their quality of life. Anyone (of any age) may receive palliative care if it is the right fit for them – it is not only offered to people with a terminal illness. Studies have found that patients with a serious illness who were given palliative care lived longer than those who did not receive this type of care. 

Palliative care may take place in a hospice, a hospital, a care home or nursing home, or in the person’s own home, and you can learn more about the latter in our guide: Palliative Care At Home: What To Expect

Who is end-of-life care for? 

End-of-life care is designed for people with a serious illness who are in the final months or weeks of their life, and require specialist care to ensure their pain is managed and they can die with dignity and in comfort. According to the NHS, end-of-life care is offered to those with a terminal illness who are expected to pass away within one year. 

For clarity, a terminal illness means an illness for which there is no cure, and that will eventually lead to the person passing away. Examples of these types of conditions could be an advanced type of cancer, a dementia condition like Alzheimer’s, motor neurone disease (MND), advanced heart disease, or another condition which is likely to cause eventual death.  

What are the key differences between palliative care and end-of-life care? 

Put simply, the aim of palliative care is to relieve a person’s pain and symptoms, while end-of-life care has the same objective, but is designed for those in the final months or weeks of their life. However, there are several other differences that set these two types of care apart:

Type of treatment and support received

• Palliative care often uses a holistic approach, so as well as medication, other methods may be explored such as physiotherapy, emotional support and more, in order to treat the person’s condition.  
• As well as physical symptom relief, end-of-life care may focus on supporting families and loved ones who are likely to experience a bereavement. 
• Families may receive additional support for the logistical and administrative side of someone’s end-of-life care, for example they may be offered advice on:
  – How to get a Power of Attorney

– What a health and welfare Power of Attorney is

– The benefits of respite care and why you might need it when your loved one requires 24/7 care

–Making an advance statement for care

– How funding works for palliative care

Goals and objectives of treatment 

• End-of-life care tends to prioritise treatments that will increase comfort rather than prioritising curative methods, like palliative care would. 
• End-of-life care also encompasses methods to help the person die with dignity and in keeping with their wishes, so there is often a spiritual element to this type of care. 
• Palliative care is more focused on improving quality of life for a person with a terminal illness, allowing them to enjoy the time they have. One study on people with conditions like Parkinson’s disease found those who received palliative care scored 3 points higher on their quality of life score than those receiving traditional treatment.

Care team involved

• Palliative care and end-of-life care are both carried out by specialist doctors and nurses, however both care teams will be trained for their respective types of care. For example, end-of-life care may include care from specialist hospice nurses or support from a spiritual counsellor, while palliative care may be provided by a doctor specially trained in care that is focused on pain relief. 

Life expectancy

• End-of-life care is typically provided for those with a terminal illness who are in the final months or weeks of their life, and this might happen if all treatment options have been exhausted, or if the person has opted to stop treatment in order to alleviate their discomfort. It is difficult to know when end-of-life care should begin, but usually this would take place when the person has a predicted life expectancy of one year or less. On the other hand, palliative care can be offered at any point if someone has a serious illness, regardless of their life expectancy. 

When does palliative care become end-of-life care? 

It can be extremely difficult to know how long palliative care lasts, and when is the right time to move from palliative care to end-of-life care. As palliative care is primarily about managing pain, this type of care can last for as long as it takes for the person’s pain to improve or until they no longer wish to receive palliative care. If they are receiving palliative care due to a terminal illness and choose to stop receiving this treatment, end-of-life care will begin. 

You may find more useful information on this in our guide: Making An Advance Decision To Refuse Treatment: A Living Will

Studies have found that the length of palliative care is largely dependent on factors such as the type of condition the person has, where their palliative care is taking place, which country the patient lives in, and other factors. The medical professional in charge of your (or your loved one’s) care will need to make a judgement call based on the person’s prognosis, how they are responding to treatment, and what their current health is like. 

This is not a decision that is made lightly, and often a team of healthcare professionals will weigh in on the best time to switch from palliative care to end-of-life care. The patient and their family (or whoever the patient would like to be present) will always be involved in the decisions made at this time, and will be given as many options as possible to ensure their health, comfort, pain and dignity are all taken into account, and their wishes prioritised. 

You may find additional information in our guide: When Should Someone Be Offered Palliative Care?

If your loved one is receiving palliative care or end-of-life care at home and requires additional support, Home Instead’s award-winning domiciliary care could provide the person-centred care needed to complement the medical professionals in charge of their palliative care or end-of-life care. Whether you require respite care to take over when you need time alone to manage your emotions, specialist cancer care to help manage difficult symptoms, or companionship to sit with your loved one for comfort, we can provide the bespoke service you need. 

Arranging this for your loved one shouldn’t be a stressful experience, so if this is something you feel could help, reach out to the Home Instead team to discuss your needs and allow us to create a personalised package to support you during this time. We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, our team can help.