Providing Quality
Hospice Care

Hospice care is a service for people with serious illnesses who choose not to get (or continue) treatment to cure or control their illness. People may choose to enroll in hospice care if the treatment is unlikely to be effective or if continuing it has become too burdensome. Hospice aims to provide comfort and peace to help improve quality of life for the person nearing death. It also helps family members cope with their loved one’s illness and can also provide support to the family after the person dies, including help with grieving, sometimes called bereavement care. Medicare reimburses for hospice services when a physician determines that a patient has a life-expectancy of 6 months or less.

Many people with a serious illness use hospice care. A serious illness may be defined as a disease or condition with a high risk of death or one that negatively affects a person’s quality of life or ability to perform daily tasks. It may cause symptoms or have treatments that affect daily life and lead to caregiver stress. Examples of serious illnesses include dementia, cancer, heart failure, and chronic obstructive lung disease.

Anyone with a serious illness who doctors think has a short time to live — generally 6 months or less —usually qualifies for hospice care. For Medicare to pay for hospice care, patients must stop medical treatment intended to cure or control their illness.

Despite the benefits of using hospice care, many people wait to receive hospice care until the final weeks or days of life. It’s important to talk with your doctor about your illness and how your disease is progressing. Starting hospice early may be able to provide months of meaningful care and quality time with loved ones.

Hospice care can provide a range of different services depending on your symptoms and end of life care wishes. These services include, but are not limited to, emotional and spiritual support for the person and their family, relief of symptoms and pain, help with advance care planning, therapy services, like physical or occupational therapy, and much more.

Hospice can be provided in many settings — a private home, nursing home, assisted living facility, or in a hospital. Many people choose to receive hospice care at home so their friends and family can visit as they wish. Other considerations may include one’s home environment vs. another setting, cost, and stability of the person’s condition. Choosing where to receive hospice care is a personal decision, but it may be helpful to talk with family members, your caregiver, or your doctor about the level of care you need and if it can be provided at home. The costs for receiving hospice care at different locations may differ.

Yes! Advance care planning involves making decisions ahead of time about the health care you would want to receive at the end of life. Studies have shown that patients who have participated in advanced care planning receive care that is more aligned with their wishes and are more satisfied with their care.

When you begin hospice care, medication and other treatments to cure or control your serious illness will stop. For example, if you are receiving chemotherapy that is meant to treat or cure your cancer, that must end before you can enter hospice care. However, a person in hospice can continue to take medications to treat other conditions or symptoms, for example, high blood pressure.

Most Medicaid, Medicare, and private insurance providers will cover some of the services provided by hospice. Older adults enrolled in Medicare can receive hospice care if their healthcare provider thinks they have 6 months or less to live. In most cases, they will need to sign a statement choosing hospice care instead of other Medicare-covered treatments for their illness.

While some may think hospice provides 24 hours a day, 7 days a week custodial care, or full-time care at home or an outside facility, this is rarely the case. Although hospice provides a lot of support, most of the day-to-day care of a person dying is provided by family and friends or caregivers. However, a person from a hospice care team is usually always available by phone 24/7.

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Most people with advanced dementia cannot communicate clearly, which means they may not be able to share their concerns with their caregivers. Caregivers may find it difficult to provide adequate care at the end of life because of this and other concerns. Hospice care can help with this situation. Hospice — whether used at home or in a medical facility — can provide caregivers and the person with dementia the support they may need near the end of life. Studies show that family members of people with dementia who received hospice report better quality of care and having more of their needs met at the end of life.

Studies have shown that when a person enrolls in hospice care they are more likely to have increased family satisfaction and better symptom and pain management. They are also less likely to undergo tests or be given medication they don’t need or want.