What is Hospice?

Hospice provides comfort and support to people nearing the end of life. This helps them and their family let go with dignity. Hospice focuses on quality of life. And it helps someone live his or her last days with a sense of control. Hospice programs support both the patient and family. They include physical, emotional, and spiritual services. This sheet tells you more about hospice. It may help you decide if this care is right for you or your loved one.

An interdisciplinary team provides hospice care.

The goals of hospice

Hospice is a special type of care for people who are ill and have about 6 months or less to live. Its goal is not to shorten life. Instead, the goal is to give comfort and support to a dying person and his or her loved ones. Hospice care helps to ease disease symptoms, like pain, nausea, and breathing problems. It also helps to meet the emotional and spiritual needs of a dying person. And those of his or her family and friends. 

Qualifying for hospice

A person with an illness can go into hospice when a healthcare provider believes he or she has about 6 months or less to live. Hospice care can be used by people in the end stages of cancer, severe lung disease, heart failure, and other diseases. Hospice continues as long as it is needed. If a person’s health improves, he or she can end the hospice care and start it again later. Also, a person in hospice has the right to leave hospice care at any time for any reason.
 

The services of hospice

Hospice is most commonly provided in the home. It can also be offered in the nursing home, assisted living facility, or hospital depending on the person's care needs. Hospice care is provided by an interdisciplinary team, which includes doctors, nurses, and other healthcare professionals. A registered nurse case manager, also known as a RN Case Manager, coordinates care provided by the hospice team. He or she also provides skilled nursing care as needed. The RN Case Manager makes weekly to daily visits based on the needs of the client and his or her family. Hospice also offers access to a social worker, home health aide, counselor, chaplain or another spiritual advisor, and others. If hospice is done at home, family members give day-to-day care. Support is given to the patient and family in many ways. These may include:

• Making sure medicines are given for the comfort of the patient
• Helping the family set up the home
• Supplying medical equipment as needed
• Helping the family arrange 24-hour care
• Helping the patient and family find emotional, spiritual, and financial resources
• Managing contact between the patient, family, and healthcare providers
• Bereavement care (helping those in mourning) must be available for a year after the patient’s death 
  
  

Common questions about hospice

Patients, families, and others may have questions about hospice care:

• Where is hospice provided? Hospice is a method of care. It is not a physical location. It may be offered in the person’s home, a nursing home, or in another facility.
• Does hospice only offer one type of treatment? People in hospice care receive treatments and interventions to give them the most comfort and quality of life. In some cases, they may have the same treatments they received before hospice. This can include palliative chemotherapy, radiation, and heart failure treatments. People can also come and go from hospice at any time. Reasons for this include if it is not meeting their needs or if a new treatment becomes available that is not able to be covered by hospice. Once a person leaves hospice, they may come back to the program at any time if they qualify, such as being determined by a healthcare provider that they only have 6 months or less to live.
• Can anyone who is ill receive hospice care? A person must have about 6 months or less to live to receive hospice.
• Do people need to have a "Do not resuscitate" (DNR) order to receive hospice? In the U.S., people are not legally required to have made DNR arrangements to have hospice care. People must be informed that taking part in hospice is a choice to accept that death is coming, and that aggressive life-sustaining treatments such as ventilator therapy, intensive care, and vasopressors are not part of hospice. 
• What is the difference between palliative care and hospice care? Palliative care and hospice care both provide comfort.  Palliative care can begin at diagnosis and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.
• What happens if a patient is still alive after 6 months? About 1 in 10 people in hospice care live beyond the 6-month limit. When this happens, the hospice staff must discharge the person. Or the person may still qualify for hospice if their healthcare provider finds they are still close to dying. In many cases, people who are discharged from hospice are hospitalized or become frail. They often pass away soon after.
• Does hospice care shorten a person' life or bring about death? No. In fact, people in hospice care have been shown to live longer than people with similar illnesses who don't use hospice.
• Can someone in hospice still keep their primary healthcare provider? Yes. Some patients fear that their primary health care provider will abandon them if they choose hospice care. This will not happen because the primary health care provider plays an important role in the care of the hospice patient.     
  
  

Who pays for hospice?

Government organizations such as Medicare and Medicaid cover hospice care for people age 65 or older. Most health insurance companies also cover hospice care. Hospice is usually available at no extra charge as a free benefit.

© 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information has been modified by your health care provider with permission from the publisher.