What Is Hospice Care?

Hospice provides comprehensive end-of-life comfort care for terminally ill patients. It also provides comfort and support to family members.

Planning ahead for the possible need for hospice care — knowing agencies in your community, discussing your wishes with family members and friends — can be one of the most important parts of planning for your retirement life. Advance planning may be much easier than handling it near your end of life.

Hospice care can begin when your doctor determines that a patient only has six months or less to live if their condition takes its natural course.

If you receive a diagnosis of a terminal condition, it’s wise to ask your doctor about hospice. In some cases a doctor may not mention it as an option, so you should bring it up.

Medicare recognizes four levels of hospice care. A patient may experience only one level, any combination of the four levels or all four levels while in hospice care.

Hospice focuses on the comfort, care and quality of life for someone with a serious, terminal illness. It is designed to help a patient nearing the end of their life — and the patient’s family — through this time when it is no longer possible to cure the patient.

Hospice is recommended when an illness or condition reaches a point at which doctors can no longer control or cure it. Typically, hospice services can begin when you are expected to live just six months or less.

When you reach this point, it’s important to discuss your hospice options with your doctor to make sure you take full advantage of hospice care while you can. Starting hospice care as soon as possible may give you a better quality of life at the end of life, and give you more time to spend with your loved ones.

Anyone, including a family member, friend, doctor or your clergy member may recommend that you seek hospice care.

You may also decide to choose hospice care when your health has rapidly declined over the previous six months despite aggressive medical treatments or if you choose to focus on your quality of life rather than pursuing treatments that may prolong but not save your life.

About half of the people entering hospice died within three weeks, and 35.7% died within one week, according to a 2014 study in the Journal of Palliative Medicine. Only about 12% to 15% of the patients in the study survived six months or longer.

The American Cancer Society recommends entering hospice as soon as you are eligible if you wish to focus on quality of life.

You can always leave hospice care if you change your mind or recover. Hospice programs will also allow you to renew care if you live longer than six months after enrolling in hospice.

Hospice care often includes palliative care, but they are two different types of care. While hospice care focuses on end-of-life care, palliative care focuses on relief of symptoms and stress of a serious illness while patients may or may not still be receiving treatment for the condition.

Most often, hospice services provide care in the patient’s home. Hospice care may be provided 24 hours a day, seven days a week, even if provided in your home.

In-home hospice care includes any type of senior housing situation. If you live in a nursing home, an assisted living facility or other senior living facility, you can receive hospice care there. It is considered in-home care as long as the facility is your home.

If you receive home hospice care, you will have services provided by doctors, nurses and other health care professionals. But a family member or friend is typically the primary caregiver who will be responsible for your around-the-clock supervision.

If you are a primary caregiver for a friend or family member receiving home hospice care, the hospice agency will train you on what you need to know and do. You will have to make sure that you — or another caregiver — are with the hospice patient around the clock, seven days a week.

Hospice professionals will check in routinely to make sure the patient’s symptoms are managed and to see how the family and caregivers are doing.

If there is a special need or the patient experiences a crisis, the hospice agency will have an on-call nurse who can take calls 24 hours a day or who can make visits or send someone if needed between regular visits.

If you are enrolled in Original Medicare, you will pay nothing for hospice care — but you may have to pay a portion of associated costs.

Medicare hospice coverage pays hospice agencies a daily rate as long as you are enrolled in hospice, regardless of the types and number of services performed on any given day. This same rate is paid even if the agency performs no services.

For example, you may have to pay 5% of the Medicare-approved amount for inpatient respite care.

You may have to continue paying room and board if you live in a nursing home or other facility. And you may have a copayment of up to $5 for each outpatient drug prescribed for symptom and pain management.