When I tell people that I work in end-of-life care, I’m often met with quiet discomfort. The subject makes people uneasy and I understand that. But I also know that our reluctance to talk about death has consequences. One of those consequences is that too many people wait too long to seek the kind of care that could truly improve their quality of life.
In the U.S., the median length of stay on hospice is just 24 days. That means most people receive hospice support for less than a month, even though the benefit is designed to support someone through the final six months of life. This delay reflects a societal pattern: we don’t talk about death until we absolutely have to, and by then we may miss out on the comfort, support, and clarity that compassionate care can offer.
This confusion is often compounded by the overlap, and misunderstanding, between two terms: palliative care and hospice care.
What Is Palliative Care?
Palliative care is specialized medical care focused on relieving the symptoms and stress of a serious illness. It’s about enhancing quality of life, no matter the stage of the illness or the age of the patient.
Importantly, palliative care is not the same as end-of-life care. It can and should be introduced as soon as someone is diagnosed with a life-limiting illness and it can be provided alongside curative treatments like chemotherapy, radiation, or surgery. Unfortunately, many patients and even some physicians mistakenly associate palliative care with “giving up,” when in fact, it’s about living as fully as possible.
When my husband John was receiving chemotherapy for colon cancer, he experienced a wide range of side effects: nausea, fatigue, loss of appetite, and what’s often called “chemo brain,” a fogginess that made it hard to concentrate. With palliative care, many of those symptoms were managed. I remember one medication in particular that helped him focus when he wanted to be fully present with friends and family. That ability to stay connected, to enjoy the moments he had — that was palliative care. It made a difference.
Palliative care can support patients with:
- Pain and symptom management
- Emotional and psychological support
- Help coordinating care
- Assistance with medical decision-making
And yet, too often it’s delayed or never offered at all.
What Is Hospice Care?
Hospice care is a type of palliative care provided specifically at the end of life. It is available when a physician determines that a patient has a prognosis of six months or less, if the illness follows its usual course. Unlike palliative care, hospice typically does not include curative treatments. Instead, it focuses on comfort, dignity, and support, both for the patient and their family. I do need to note that in the case of a child, curative treatment does not need to end when hospice care begins.
Hospice provides:
- Medical care to manage symptoms
- Emotional and spiritual support
- Grief counseling for loved ones
- A team-based approach that includes nurses, social workers, chaplains, and volunteers
But as with palliative care, many families wait too long to make the call. By the time hospice is involved, the patient may be in crisis and the full spectrum of support may come too late.
Why Timing Matters
One of the most heartbreaking things I’ve witnessed in my work is how often people suffer unnecessarily because of a delay in receiving the right kind of care. When palliative care is introduced early, it helps patients feel better physically and emotionally. It supports decision-making, reduces hospitalizations, and often improves satisfaction for both patients and families.
When hospice is started earlier, meaning before the final days or hours, it provides time for relationships to deepen, for meaningful conversations to happen, and for comfort to truly take root.
Words Matter: It’s a Journey, Not a Battle
Our culture often uses the language of war to talk about illness. We say someone is “fighting cancer” or has “lost their battle.” But that language never sat right with me. It implies that the outcome is a measure of willpower, or worse, that death is a failure.
I don’t use those terms. I think of illness as a journey, one filled with choices, reflection, courage, and love. Palliative and hospice care are not signs of defeat. They are powerful ways to reclaim agency, comfort, and connection. They allow individuals to decide what matters most and to live (and die) on their own terms.
Moving Forward
If you or someone you love has been diagnosed with a serious illness, I encourage you to ask early about palliative care. If curative treatment is no longer working, talk to your care team about hospice, not as a last resort, but as a source of support and peace.
Every journey is personal. Let’s make space for more compassionate conversations, sooner.
If you’d like help navigating this journey, whether for yourself or someone you love, I’m here to help. Book a free 20-minute Peace of Mind Planning Session to talk through your questions, wishes, and options.
