The Frederick Regional Health System in Frederick, MD, has created an advance care planning educational program for people and providers in the community. Below are the health system’s definitions of palliative care vs. hospice care, and its definitions of advance directives.

  • Palliative (Supportive) Care
    • Care focused on improving the quality of life of patients with serious, chronic, or life-threatening disease.
    • Provided across the continuum of the disease, not just at end of life.
    • Focus is on symptom management and overall wellness.
    • Can include treatment for side effects, psychological, social, and spiritual needs.
    • Often used interchangeably (incorrectly) with hospice care.
  • Hospice
    • Care focused on quality of life, but for patients with a prognosis of six months or less.
    • Provides comfort-oriented care that neither hastens death nor prolongs life.
    • Manages symptoms, eases physical, emotional, and spiritual pain.
    • Embraces the patient and family.
    • Volunteers provide patient support and caregiver respite.
    • Provides grief support and counseling for bereaved.
  • Living Will
    • Provides instructions for future treatment at end of life.
    • Directs that life-sustaining treatment be withdrawn or withheld when person is (a) in a terminal condition, or (b) in persistent vegetative state, or (c) end-stage condition.
    • Does not guide EMS personnel.
    • Guides inpatient treatment.
    • Does not need to be notarized in Maryland.
    • Generally is portable from state to state.
  • Healthcare Agent
    • A person(s) (Agent) to make healthcare decisions for you when you are unable to make decisions for yourself.
    • Able to consult with doctor, view medical records, and make all decisions related to healthcare of patient.
    • Is bound to make decisions according to wishes of the patients.
  • MOLST: Medical Orders for Life-Sustaining Treatment
    • Medical orders for current treatment. It is intended to stay with the patient as he/she moves into/out of various healthcare facilities and settings (e.g., assisted living, home with home healthcare, nursing home, hospital, hospice).
    • Needs to be signed by a physician, physician’s assistant, or nurse practitioner.
    • Does guide EMS personnel.
  • Financial Power of Attorney (POA)
    • A person who will conduct business on your behalf if you should become unable to do so (e.g., pay bills, sell property, etc.).
    • Does not apply to making healthcare decisions — the Durable Medical Power of Attorney is required for that.
    • The same person can be your Financial POA and your Medical POA, or they can be two separate individuals.