Hospice Care
Hospice Care
Compassionate care focused on comfort, dignity, and quality of life for people with terminal illnesses
Who Qualifies:
- Life expectancy of 6 months or less (if illness runs normal course)
- Decision to focus on comfort rather than cure
- Physician certification of terminal diagnosis
Key Features:
- Focuses on comfort and emphasizes quality of life
- Treats the person, not just the disease
- Supports both patient and family
- Provides dignity and respect
- 24/7 on-call support
- Care in familiar surroundings (usually at home if feasible)
Signs It May Be Time:
- Frequent hospitalizations
- Declining functional status
- Uncontrolled symptoms
- Weight loss and decreased appetite
- Increased need for assistance
Common Conditions:
- Advanced cancer
- End-stage heart disease
- Advanced COPD
- End-stage kidney disease
- Advanced dementia
- ALS (Lou Gehrig's disease)
Medical Services:
- Pain and symptom management: Expert comfort care
- Nursing care: Regular visits and assessments
- Physician services: Medical oversight
- Medical equipment: Hospital bed, oxygen, etc.
- Medications: Related to terminal diagnosis
Support Services:
- Social work services: Counseling and resources
- Spiritual care: Chaplain services
- Home health aide: Personal care assistance
- Volunteer services: Companionship and support
- Bereavement support: Grief counseling for family
Hospice Medical Director
Oversees medical care and pain management
Registered Nurse
Coordinates care and provides nursing services
Social Worker
Provides counseling and connects to resources
Chaplain
Offers spiritual and emotional support
Home Health Aide
Assists with personal care and daily activities
Volunteers
Provide companionship and practical support
Bereavement Counselor
Supports family through grief process
Other Specialists
Therapists, dietitians as needed
Most Common Locations
- At home (70%): Most people prefer familiar surroundings
- Nursing homes: For those already residing there
- Assisted living: In their current residence
- Hospice facilities: Specialized inpatient care
Inpatient Hospice Care
- For symptom management that can't be done at home
- Respite care to give family caregivers a break
- Crisis situations requiring immediate attention
- When home environment isn't suitable
Routine Home Care
Regular visits and on-call support at home
Continuous Home Care
8+ hours of nursing care at home during crisis
Inpatient Respite Care
Short-term facility care to give family a break
General Inpatient Care
Hospital-level care for symptom management
Medicare Coverage:
- Medicare Part A covers hospice care
- Covers all services related to terminal diagnosis
- Includes medications, equipment, and supplies
- No deductible for hospice services
- Small copays for medications and respite care
Other Insurance
- Most private insurance covers hospice
- Medicaid covers hospice in most states
- Veterans may have VA benefits
- Some hospices offer charity care
What's Typically Covered
- All medical services
- Medications for comfort
- Medical equipment and supplies
- Nursing and aide services
- Counseling and spiritual care
"Does choosing hospice mean giving up hope?"
No. Hospice shifts hope from cure to comfort, quality time with loved ones, and living as fully as possible. Many families find great meaning and peace in hospice care.
"Will hospice hasten death?"
No. Hospice neither hastens nor postpones death. Studies show hospice patients often live as long or longer than those receiving aggressive treatment, with better quality of life.
"Can we change our minds?"
Yes. Patients can revoke hospice care at any time and return to curative treatment. They can also re-enroll in hospice later if desired.
Getting Started
- Talk with your doctor about hospice
- Ask for a hospice referral
- Contact hospice organizations directly
- Hospital social workers can help
What Happens Next
- Hospice nurse visits for assessment
- Care plan is developed
- Team members are assigned
- Services begin immediately
Questions to Ask:
- What services do you provide?
- How quickly can you respond to urgent needs?
- What is your on-call coverage like?
- How do you manage pain and symptoms?
- What support do you offer families?
- Do you have inpatient facilities if needed?
- What happens if we want to stop hospice care?
- How long do you provide bereavement support?