What Is Hospice Care?

What hospice care isExplain▾

Hospice is a special type of care in which medical, psychological, and spiritual support are given to people with cancer and their loved ones when therapies are no longer controlling the disease. With hospice care, a team of health care professionals works with patients and families to provide the comfort and care they need closer to the end of life.

Hospice is a focus on caring, not curing. The goal is to help you live each day to the fullest by controlling pain and other symptoms and making you as comfortable as possible. It is not intended to either hasten or postpone death.

Hospice is not the same as palliative careExplain▾

These two kinds of care are often confused, and the difference matters:

• Palliative care is available throughout a person's experience with cancer. A person's cancer treatment continues while they receive palliative care.
• Hospice care shifts the focus to just relieving symptoms and providing support at the end of life.

Both hospice and palliative care provide comfort and support for patients—the difference is the timing and the goal of care.

Choosing hospice is not giving up hopeExplain▾

Choosing hospice care doesn't mean that you've given up hope. Instead, it means you're changing what you hope for. This could be hoping for good quality of remaining life, including more time with loved ones and friends.

All patients have a right to comfort and quality of life throughout their care.

Where hospice happens and what it includesExplain▾

Hospice care most often takes place at home, but it can also be provided in special inpatient facilities, hospitals, and nursing homes. It can also take place along with professional home care if necessary.

Services differ depending on where you live and the philosophy of the hospice itself, but generally include:

• medical and nursing services
• medical supplies and equipment
• drugs for managing cancer-related symptoms and pain
• short-term inpatient care
• volunteers to give caregivers a break
• counseling and spiritual care
• social work services
• grief counseling and support

The hospice teamExplain▾

Hospice professionals and volunteers are specially trained. They are committed to supporting the emotional needs of both patients and their families and are trained to deal with medical symptoms.

The hospice team usually includes doctors, nurses, home health aides, social workers, clergy or other counselors, and trained volunteers. It may also include speech, physical, and occupational therapists if needed. The team focuses on your goals for end-of-life care and bases your care plan on your needs and desires.

When hospice starts and how long it can lastExplain▾

Many people believe hospice is only available in the last days or weeks of life, but hospice can provide support for months. Many people have said they wished hospice care had begun earlier—they were surprised by the expert care and understanding they got from hospice caregivers.

Your doctor must certify that you are eligible for hospice care. Most insurance plans, including Medicare, cover hospice care once they receive a statement from both your attending doctor and the hospice medical director that you have a life expectancy of 6 months or less. You would also sign a statement saying you are choosing hospice care. Hospice care can continue if you live longer than 6 months, as long as your hospice doctor recertifies your condition.

You can stop hospice care if you chooseExplain▾

You always have the option to stop hospice care. Sometimes patients change their mind, decide to switch to another hospice provider, or their situation changes in some other way. Less common, but not unheard of, patients may be discharged from hospice if their condition improves or if they resume cancer treatment.

If you have questions about whether certain decisions—such as getting a second opinion or joining a clinical trial—would affect eligibility for hospice services, the hospice team or your insurance provider can answer them. Often, people receiving hospice care aren't eligible for a clinical trial for reasons such as their past medical care, their current physical or mental condition, or their ability to travel to appointments.

Paying for hospice and choosing a programExplain▾

Medicare and most Medicaid and private insurance plans pay for hospice services. The Medicare hotline (1-800-MEDICARE) can answer questions about hospice benefits and Medicare-certified hospice programs, and information about Medicaid coverage is available from state offices. Your hospital business office, hospice social worker, or insurance company can explain what private health policies cover. Local civic, charitable, or religious organizations may also be able to help patients and their families with hospice expenses.

Once you decide to use hospice care, talk to organizations as soon as you can. Not all hospices provide the same services, and the medicines they cover vary. Talk to family and friends who have used hospice services, and ask your health care team who they would suggest. Organizations such as the National Hospice and Palliative Care Organization have databases to help you find and compare hospices in your area.