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What is hospice care?

Hospice is designed to provide nearly all of the necessary services to support people approaching end of life. Hospice includes care that will not hasten death, but it will not prolong the dying process either. It provides relief of suffering due to any cause, including those that are physical, psychological, social and spiritual. Hospice services are available when people are expected to live six months or less.
 
Hospice can be provided where the person lives, or in the hospital, a nursing facility, or a hospice. Hospice services include an interdisciplinary team of doctors, nurses, social workers, chaplains, home health aides, and others such as massage and music therapists.

Medicines necessary to treat terminal illness are provided by hospice. This includes medicines for symptoms such as pain and nausea. It also includes medicines still needed for management of your underlying condition. Hospice will cover the pharmacy costs; however, there may be medications that are not directly related to the terminal condition. Insulin for diabetes, for example, will continue to be covered by traditional means. This will not be covered by the hospice.

Hospice provides equipment. This may include hospital beds, oxygen, wheelchairs and walkers. Diapers, “chucks” (absorbent pads) and other routine supplies may not be provided by the hospice.

Laboratory and other tests are kept to a minimum. These tests may be provided when the information helps manage symptoms.

Respite care is available to the family. It allows admission to a facility for five days. This allows the family to re-energize as they care for their family member. Hospice is the only Medicare service with this benefit. It recognizes the stress and fatigue caregiving can create.

Hospices must follow a number of rules to be approved and paid by Medicare. They also are paid a fixed amount for each day of care provided to people. This means they must carefully watch their budget to continue providing services. From time to time, the policies related to Medicare benefits may change. More information can be found from your doctor or at the Medicare website.

Hospice providers often have similar philosophies and services. However, you may want to speak with several hospice providers before making your choice. Some hospice providers may be more sensitive to your needs.
Philip Lisagor, MD
Thoracic Surgery (Cardiothoracic Vascular)
Hospice provides comfort care for terminally ill people. Hospice caregivers can help with a terminally ill person’s daily activities and medical needs. They can also help people, their families and loved ones deal with their psychological and spiritual needs when facing the end of life. Hospice care can be received at home or in a facility. Family and friends often provide what comfort care they can, with skilled help from the hospice staff tailored to their needs. Hospice providers do not necessarily provide round-the-clock care and the length of time for services (for example nursing, social work, etc.) varies.
Once a word that evoked shelter for tired and ill religious pilgrims, the term hospice has come to describe a concept of end-of-life care centered on quality of life. Hospice care -- which encompasses physical, emotional, and spiritual needs -- may take place at home or at a nursing home, assisted living center, or hospice residence. When a cure is not possible and aggressive treatment isn't desired, hospice care offers symptom relief, pain control, and a great deal of support.

The hospice team works with the patient to develop a personal plan of care. Family, partners, and close friends may be invited to help in many ways, such as by assisting with daily tasks like feeding and bathing and offering comfort by reading, sharing music, holding hands, and simply being present.
Hospice is a concept of care designed to provide comfort and support to individuals (as well as their family and friends) who have a life-limiting illness that no longer responds to curative treatment.

Hospice is not intended to prolong life or hasten death, but rather to improve the quality of the patient's remaining life by offering comfort (control of pain and discomfort) and dignity. Hospice also focuses on the emotional, social and spiritual impact of the illness on the patient as well as his or her family and friends. Hospice offers grief counseling before and after the death.

Most of the time, hospice care is provided in the home or nursing home.
Anne Fabiny
Geriatric Medicine
Hospice is primarily a service, not a place. A quarter of Americans who enter hospice get this care in hospitals or dedicated hospice facilities, but in this country, hospice is increasingly organized and financed as a service. About half of hospice patients get the services at home, and about a quarter get them in nursing homes.
Sharine Forbes
Geriatric Medicine

It was in 1967 that the term “hospice” was first utilized by Dame Saunders in London to describe the type of specialized services and care that patients with terminally ill diseases were receiving. The term hospice is used when a patient can no longer be treated and cured from a disease and has been given 6 month of life to live. The idea of hospice care is to make the dying patient as comfortable as possible in the last phases of their life. This is also referred to as palliative care, which helps relieve the symptoms associated with the disease. In order to achieve a level of comfort care is offered twenty-four hours a day and seven days a week. However, it is important to note that hospice care is not solely limited to take place in a hospital setting. It is quite popular for an individual to receive hospice care in their home, nursing home and even private hospice locations. 

Hospice services are family-centered and are delivered by a team of specially trained and compassionate healthcare professionals and volunteers. They work with patients, loved ones, and the caregivers to help ease the pain and stress that can occur during advanced illness.

The term palliative care is often used to describe the type of care given in hospice programs. Palliative care emphasizes the total well-being of the survivor as well as that of loved ones and caregivers. The goal is to prevent, treat, or eliminate discomfort whenever and however it appears.

Hospice care gives patients and their loved ones a chance to make meaningful decisions that are respected. Hospice is not about giving up hope. An important goal is to help the patient to be free of pain to give the patient and his or her loved ones, friends, and caregivers peace of mind and acceptance of life as it is.

Some people are afraid to ask about hospice care for themselves or for a loved one. They may believe that choosing hospice care means giving up. However, these programs are not about giving up. Rather, they allow the patient and his or her caregivers to focus time and energy on quality of life.

A hospice organization provides care through a team of professionals and volunteers who work closely with the patient and all of the caregivers and loved ones who want to be a part of this experience. Hospice care workers are trained to support the physical, emotional, spiritual, and practical needs of all those who are supporting loved ones at the end of life.

Hospice care is often provided in the patient’s home with a loved one, friend, and/or hired caregiver managing day-to-day care. The professional hospice team makes regular visits to provide additional services.

Hospice care services may also be provided in other locations such as:

  • The home of the caregiver, friend or loved one
  • A hospice facility
  • A retirement or board and care home
  • An assisted living facility
  • A nursing home
  • A hospital
Hospice care provides humane and compassionate care for people in the last phases of incurable disease so that they may live as fully and comfortably as possible.
Hospice is a philosophy of care. The hospice philosophy or viewpoint accepts death as the final stage of life. The goal of hospice is to enable patients to continue an alert, pain-free life and to manage other symptoms so that their last days may be spent with dignity and quality, surrounded by their loved ones. Hospice affirms life and does not hasten or postpone death. Hospice care treats the person rather than the disease; it focuses on quality rather than length of life. Hospice care is family-centered care -- it involves the patient and the family in making decisions. Care is provided for the patient and family 24 hours a day, 7 days a week. Hospice care can be given in the patient's home, a hospital, nursing home, or private hospice facility. Most hospice care in the United States is given in the home, with a family member or members serving as the main hands-on caregiver.
Hospice care is meant for the time when cancer treatment can no longer help you, and you are expected to live 6 months or less. Hospice gives you palliative care, which is treatment to help relieve disease-related symptoms, but not cure the disease; its main purpose is to improve your quality of life. You, your family, and your doctor decide together when hospice care should begin.
One of the problems with hospice is that it is often not started soon enough. Sometimes the doctor, patient, or family member will resist hospice because he or she thinks it means you're giving up, or that there's no hope. This is not true. If you get better or the cancer goes into remission, you can be taken out of the hospice program and go into active cancer treatment. You can go back to hospice care at a later time, if needed. The hope that hospice brings is the hope of a quality life, making the best of each day during the last stages of advanced illness.

Continue Learning about Hospice Care

What Is Hospice Care?
What Is Hospice Care?
The end of life can be an emotionally and physically difficult time. Most adults say they’d prefer to die at home, pain free and surrounded by friends...
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Is hospice care available in hospitals?
Niamh van MeinesNiamh van Meines
Yes. Most hospitals provide both palliative care and hospice care. Some hospitals contract with hosp...
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How can I prepare for hospice?
Philip Lisagor, MDPhilip Lisagor, MD
The reality of hospice care requires a number of adjustments -- from accommodating the annoyance of ...
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What types of assistance can a hospice program provide?
Brett SnodgrassBrett Snodgrass
Hospice care is for the terminally ill.  The actual criteria to be placed in hospice care is for a p...
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.