Hospice is end-of-life care. Many people associate hospice with cancer patients who no longer wish to receive treatment, but hospice care is an option for anyone with 6 months or fewer to live.
When you receive hospice care, you’ll no longer be receiving care that’s meant to cure your condition or extend your life. Instead, you’ll receive care intended to relieve your pain and make the time you have remaining as comfortable as possible.
When a person receives a terminal diagnosis, they can choose to receive hospice care.
Hospice is medical care designed for the end of someone’s life. The purpose of hospice is to improve the quality of life that’s left. Hospice provides pain and other symptom relief, as well as emotional, psychosocial, and spiritual help to support you and your family.
There are four types, or levels, of hospice care:
- Routine home care. Routine home care is the standard level of most hospice care. When you receive routine home care, your hospice team will come to where you live to provide nursing, therapeutic, spiritual, and other care. Your hospice team will coordinate this schedule with you and your family.
- Continuous home care. If you’re having a medical emergency or need around-the-clock care, your hospice team will provide continuous home care. For example, if you were experiencing severe pain that wasn’t relieved by your current medications, a nurse might stay with you for an extended period of time to resolve the issue.
- General inpatient care. Some symptoms can’t be managed at your home. In this case, the hospice physician might recommend an inpatient hospital or inpatient hospice stay. At your inpatient stay, your symptoms will be addressed so that you can return to receiving routine hospice care at home.
- Respite care. Respite care is short-term care that provides a break to family caregivers. When you receive respite care, you’ll stay at an inpatient hospice, a skilled nursing facility, or a hospital for a set period of time. Respite care can help family members who need to travel, are having their own health concerns, or simply need a break from full-time caregiving.
The hospice care level won’t affect the quality of the care you receive. Your setting might change temporarily, but your plan of care won’t. All hospice providers that are certified by Medicare are required to provide all four care levels.
The goal of hospice care is to help a person who has a terminal diagnosis have the highest possible quality of life. Instead of performing tests and procedures, hospice care provides relief from pain or other symptoms, as well as emotional and spiritual support.
Once you enter hospice care, you’ll be asked to appoint a primary caregiver — typically a family member or close friend. This person will work closely with your care team to communicate your needs and develop a customized plan.
Your care team will consist of healthcare professionals including:
- nursing assistants
- physical therapists
- occupational therapists
- speech therapists
- social workers
- medical chaplains
The exact services you receive will depend on your condition, needs, and preferences, but will often include:
- medication for pain relief
- medication to manage other symptoms
- mobility aids such as wheelchairs and walkers
- medical supplies you need for care at home
- physical, occupational, and speech therapy as needed
- meal planning and nutrition services
- treatments to relieve symptoms and pain
- grief counseling and emotional support for you and your family
- care coordination
- assistance with bathing, eating, and other activities of daily living
Generally, you’ll stay where you currently live to receive hospice care. Your care team members will come to you as needed throughout the week and will be available 24/7 if you have additional needs. Your hospice plan will be built around you and your needs.
Your family will be part of the process and will also receive support. Your team will monitor you and adjust your care as your illness progresses.
Hospice care starts at the end of your life. When you enroll in hospice care, you agree to stop treatments aimed at curing your condition. You, your family, and your healthcare provider can discuss when it might be time for hospice care. You’ll normally need to meet these criteria:
- A doctor states you have 6 months or fewer to live.
- You’re actively declining and no medical treatments are helping.
- You’re ready to stop treating your condition.
Your hospice care will be reevaluated every 6 months. Your care will continue if you’re still declining and hospice is still appropriate. If hospice care is no longer right for you, the care can stop. You’ll be able to restart hospice care at a later time if you need to.
You can receive hospice care in a number of settings. Most hospice care is done where you live. That can mean several things depending on your situation. You could receive hospice care:
- in your home
- in the home of a relative or other caregiver
- at an assisted living facility
- at a skilled nursing facility
You can also receive hospice care at an inpatient hospice center. Some hospices operate long-term hospice facilities. You can live at this facility the entire time you’re receiving hospice care if this option is available.
No matter where you receive hospice care, care is intended to be available to you 24/7.
How to find hospice care
After you and your family decide it’s time for hospice care, you can contact hospice providers in your area to get started. That can seem overwhelming, especially when you’re already processing the decision to go on hospice care, but there are ways to make it much easier. Some ways to find hospice care include:
- Ask your doctor what hospice care they recommend.
- Ask friends and family if there are any local hospices they recommend.
- If you’re in a hospital or long term care facility, you can ask a social worker to help you find the best hospice for you.
- Meet with hospices and see you who feel comfortable with.
You can get hospice coverage with most private insurance. The exact amount covered will depend on your plan. You can check with your plan before you enroll in hospice if you’re not sure.
You’ll also have hospice coverage if you have a government insurance program such as a Medicare, Medicaid, Tricare, or Healthcare Marketplace plan.
Many plans will cover your hospice costs at 100 percent. However, there might be eligibility rules. For example, you’ll need to choose a Medicare-approved hospice provider if you’re planning to use Medicare or a Medicare Advantage plan for your coverage.
Almost all hospices will accept out-of-pocket payment if you don’t have any type of insurance. Depending on your situation, you might be able to find help paying for your care. Many hospices will provide charity care even if you can’t afford to pay.
There is hospice care available no matter your insurance or financial situation. Ask your hospice team if you’re worried about payment. Admissions or social services staff can help you figure out your insurance, set up a payment plan, arrange for charity care, and help you explore all your options.
Help paying for hospice care
Most people who need hospice are able to have this care. There are many options to help cover the costs, such as:
- Medicare. If you’re enrolled in Medicare, your coverage includes hospice care.
- Veterans’ Administration (VA) benefits. If you’re a veteran, your VA benefits cover hospice care.
- Medicaid. If you have Medicaid coverage, you must choose to receive hospice coverage and stop Medicaid covered services. You may switch back to Medicaid-covered medical care later if appropriate.
- Private insurance. Most private insurance covers hospice care. Check with your carrier to understand your benefits.
- Other financial support. Most hospice organizations and many hospitals have programs to pay for hospice care for individuals who are uninsured.
It’s easy to get the terms hospice care and palliative care confused, but they refer to two different types of care.
Both hospice and palliative care are for people with diagnoses of serious illnesses. However, you can use palliative care throughout treatment of a condition, not just at the end of life.
Palliative care can start the moment you get a diagnosis. Palliative care can provide support to you and your family and can help you make decisions about the care you receive.
The primary difference between palliative and hospice care is that hospice care is only available at the end of your life. A doctor needs to certify you have 6 months or fewer to live. You can receive palliative care at any time as long as you have a diagnosis of a serious and chronic condition.
Palliative care can help you manage your pain and other symptoms, but you can still receive treatments for your condition during palliative care. Most palliative care is done outpatient, although some palliative care providers might offer home care as well. Additionally, you can receive palliative care for as long you need it and your insurance will cover it.
Hospice care is designed to make the last 6 months of your life as comfortable as possible. Hospice provides relief from pain and symptoms along with support for you and your family.
Hospice care is often provided at home, although long-term inpatient hospice care is also available.
Most insurances will pay for hospice care. If you don’t have insurance and have a limited income, you might be able to receive free hospice care through an assistance program.