Disclaimer Notice:
This guide is general information, not medical or legal advice. Medicare rules change. Figures last verified October 2026 against Medicare.gov and CMS. Confirm current details with Medicare, your parent’s plan, or the hospice provider.
When a parent has a serious illness, sooner or later a doctor or nurse brings up “palliative care” or “hospice.” For a lot of families, both words sound like giving up. They’re not. Both focus on comfort and quality of life, and many families say afterward they wish they’d started sooner.
But they aren’t the same thing, and the differences matter for your parent’s treatment, where they get care, and what Medicare pays for. Here’s a plain-language breakdown.
The short version
- Palliative care is comfort-focused care for anyone with a serious illness, at any stage. Your parent can keep getting treatment meant to cure or control the illness (like chemo, dialysis, or heart medications) at the same time.
- Hospice is comfort-focused care for someone who is expected to have six months or less to live if the illness runs its usual course, and who has decided to stop treatment aimed at curing the illness.
All hospice is palliative, but not all palliative care is hospice.
What palliative care is
Palliative care is an extra layer of support for people living with serious illnesses such as cancer, heart failure, COPD, kidney disease, Parkinson’s, or dementia. A palliative care team, often a doctor, nurse, and social worker, works alongside your parent’s other doctors.
What it helps with:
- Pain, shortness of breath, nausea, fatigue, and other symptoms
- Anxiety, depression, and sleep problems
- Understanding treatment options and what to expect
- Planning ahead: what your parent wants if their health gets worse
- Support for family caregivers
Who can get it: Anyone with a serious illness, at any age and any stage. There’s no requirement to stop treatment and no life-expectancy limit.
Where it happens: Most often in hospitals and outpatient clinics. Some programs offer home visits.
How it’s paid for: Palliative care is generally billed like other medical care. Medicare Part B covers doctor and nurse practitioner visits, with the usual copays or coinsurance. Coverage varies by setting and plan, so ask the palliative team what your parent’s insurance pays.
What hospice is
Hospice is for the final stage of an illness. The focus shifts completely to comfort, dignity, and making the most of the time left, for your parent and the family.
Who qualifies under Medicare:
- Your parent has Medicare Part A
- Their doctor and the hospice medical director certify they’re terminally ill, with a life expectancy of six months or less if the illness follows its normal course
- Your parent (or their health care agent) chooses hospice and signs a statement choosing comfort care instead of treatment to cure the terminal illness
Six months is an estimate, not a deadline. Many people live longer. Medicare covers hospice in benefit periods: two 90-day periods, then an unlimited number of 60-day periods, as long as a doctor recertifies that your parent is still terminally ill.
What Medicare’s hospice benefit covers: Through a Medicare-approved hospice, generally:
- Nurse visits and an on-call nurse 24/7
- Doctor services
- Home health aide help with bathing and personal care
- Medications for pain and symptom control related to the terminal illness
- Medical equipment like a hospital bed, wheelchair, or oxygen
- Supplies like bandages and incontinence products
- Social work and spiritual care
- Short-term inpatient care for symptoms that can’t be managed at home
- Respite care: a short stay in a facility (up to five days at a time) so family caregivers can rest
- Grief support for the family for about a year after a death
What your parent pays: Usually very little. There may be a small copay (up to about $5) per prescription for symptom-control drugs and a small coinsurance for inpatient respite care.
What Medicare hospice doesn’t cover:
- Treatment meant to cure the terminal illness
- Room and board if your parent lives in a nursing home or assisted living (hospice comes to them there, but doesn’t pay the rent)
- 24-hour in-home caregivers. Hospice provides visits and support, but family or paid caregivers still do most day-to-day care at home.
Your parent can still get Medicare coverage for health problems unrelated to the terminal illness.
Where it happens: Most hospice care happens wherever your parent lives: their home, a family member’s home, assisted living, or a nursing home. Some areas also have inpatient hospice houses.
Side-by-side comparison
| Palliative care | Hospice | |
|---|---|---|
| Who it’s for | Anyone with a serious illness | People with a terminal illness and about 6 months or less to live |
| Curative treatment | Can continue | Stops for the terminal illness |
| When to start | Any time after diagnosis | When treatment is no longer helping or wanted |
| Where | Mostly hospital or clinic; some home programs | Mostly at home or where your parent lives |
| Medicare coverage | Regular Part B (and Part A in hospital) | Medicare hospice benefit (Part A), very low out-of-pocket |
| Family support | Some | Extensive, including respite and grief support |
Can my parent change their mind?
Yes. Your parent can leave hospice at any time, for example to try a new treatment, and go back to regular Medicare coverage. They can come back to hospice later if they still qualify. Some people “graduate” from hospice when their condition stabilizes.
Your parent can also change hospice providers once per benefit period.
Signs it may be time to ask about hospice
- Frequent hospital or ER visits, especially for the same problem
- Treatments are no longer working, or the side effects outweigh the benefits
- Your parent is tired of treatment and says so
- Steady weight loss, sleeping most of the day, or needing help with most daily tasks
- A doctor says, “I wouldn’t be surprised if…” or asks about goals of care
Asking about hospice isn’t a commitment. A hospice can do an informational visit to explain services and whether your parent qualifies.
How to choose a hospice
Several hospices serve the Northwest Suburbs. They aren’t all the same.
- Check ratings and family survey results on Medicare’s Care Compare (medicare.gov/care-compare), which includes hospice providers
- Ask how quickly a nurse will come in a crisis, including nights and weekends
- Ask how often the nurse and aide will visit
- Ask whether they have an inpatient unit or contracts with local facilities
- Ask what respite care looks like and where it’s provided
- Ask about dementia experience, if that applies
- Ask what grief support they offer the family
Your parent’s doctor, hospital social worker, or AgeOptions (708-383-0258) can also suggest local options. See our Hospice topic page for more resources.
Talking with your parent about it
These are hard conversations, and there’s no perfect script. A few things that help:
- Ask what matters most to them. “If things get harder, what’s most important to you?” Answers like “being at home” or “not being in pain” guide the decisions.
- Use their words. If your parent says “I’m tired of all these hospital trips,” that’s an opening.
- Bring in the doctor. Ask the doctor to explain options directly, with you there.
- Get wishes in writing. A health care power of attorney and a written statement of wishes (and, if appropriate, a POLST form signed with their doctor) make sure their choices are followed.
- Include siblings early. End-of-life decisions are where family disagreements hurt most. See our guide on talking to siblings about a parent’s care.
Taking care of yourself
Caring for a parent at the end of life is exhausting and emotional. Use the respite care hospice offers. Accept help. Hospice social workers and chaplains are there for the family too, not just the patient. And after a loss, hospice grief support is available to you for about a year. Our caregiver burnout guide has more on getting support.
Editorial Review Status
Reviewed for: Medicare hospice benefit eligibility, the six-month prognosis standard, covered services, cost-sharing, benefit periods, and the distinction between palliative and hospice care.
Elder care regulations, costs, and local provider availability change frequently. We commit to regular audits to ensure Gen X families have the most accurate data for the NW Chicago suburbs.
Disclaimer: This guide is educational only and is not legal, financial, medical, or tax advice. Confirm details with a qualified professional before making decisions.
FAQ
Does choosing hospice mean giving up?
No. It means changing the goal from cure to comfort. Many families find hospice gives their parent better symptom control and more good days at home.
Can someone with dementia get hospice?
Yes, in later stages when they meet Medicare’s criteria. Hospice can be a big help for families caring for a parent with advanced dementia.
Does hospice mean someone is there 24 hours a day?
Usually not. Hospice provides regular visits and a nurse on call 24/7, but family members or paid caregivers provide most day-to-day care at home. Continuous nursing at home is available only for short-term crises.
Does Medicare pay for palliative care?
Medicare Part B generally covers palliative care visits with doctors and nurse practitioners, with the usual cost-sharing. Coverage depends on the setting and your parent’s plan.
What if my parent lives longer than six months on hospice?
They can keep receiving hospice as long as a doctor recertifies that they’re still terminally ill. There’s no limit on the number of 60-day benefit periods.
Does hospice pay for a nursing home?
Hospice can provide care to a parent living in a nursing home, but Medicare’s hospice benefit doesn’t pay room and board. That’s paid privately, by long-term care insurance, or by Medicaid if your parent qualifies.
This guide is general information, not medical or legal advice. Medicare rules change; confirm details with Medicare or the hospice. Last verified October 2026.