What is hospice care?

How end-of-life care works

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    Also known as end-of-life care, hospice care provides comfort and support for those of advanced age or with terminal illnesses who are in their final days. This type of care focuses on pain relief and comfort for both the patient and their family.

    At this stage, rather than treating the underlying illness, staff at hospice care facilities treat the patient and their symptoms, making their last days as comfortable as possible.

    Key insights

    • Hospice care involves physical, emotional and spiritual support for the patient and emotional assistance and bereavement support for their families.
    • Hospice services cover a wide spectrum, including symptom management, emotional counseling, spiritual care, assistance with daily tasks and medication management.
    • Hospice care can take place in patients' homes, assisted living facilities or nursing homes.
    • Hospice care is different from palliative care: Palliative care aims to improve the patient's well-being at any point of a serious illness, but hospice care is specifically for patients with a prognosis of up to six months.

    How hospice care works

    Hospice care provides holistic support for a patient’s physical, spiritual and emotional needs, as well as emotional support for their family.

    Both in-home and inpatient hospice services offer symptom management, emotional support, counseling services and spiritual care with a religious leader of your choice. Hospice care also includes respite care, family meetings and bereavement support for family members.

    Most hospice caregivers provide the following:

    • Bathing and dressing assistance
    • Food preparation
    • Assistance with chores
    • General companionship
    • Appointment and medication management
    • Counseling

    These services include any necessary medical equipment or medications. The facility may include short-term inpatient or respite care if the patient is still at home — the goal is to keep the patient comfortable and alert, and hospice involves the services of doctors, nurses, counselors, religious advisors and social workers.

    » MORE: How to deal with a loss of independence

    Palliative care vs. hospice care

    Palliative care helps people with terminal illnesses live comfortably — but, unlike hospice care, it can start the moment the patient is diagnosed. It aims to enhance the well-being of patients dealing with serious illnesses, whether the illness is curable, chronic or life-threatening. It doesn't interfere with curative treatments and can begin at any phase of the illness. Its focus is on alleviating pain, symptoms and emotional distress associated with serious illnesses.

    Hospice care is typically reserved for those with no more than six months to live. Its aim is to make the patient comfortable in their final days.

    Hospice care, on the other hand, is typically for patients with a life expectancy of no more than six months. Hospice care is often the better choice if the priority is to ensure comfort and a high quality of life during the final stages of an illness.

    Palliative care is often more suitable for severe but non-terminal illnesses. If the main goal is to extend life through curative treatments, palliative care could make sense.

    How much does hospice care cost?

    Hospice care tends to range in cost from $150 to $1,400 per day as of publishing, varying based on the level of care. Home care is a lower-cost option, while end-of-life care in hospitals and care facilities is more expensive, potentially amounting to around $10,000 per month for the average patient. For specialized pain control and symptom management at an inpatient facility, the cost is about $1,040 per day.

    » MORE: What is the cost of in-home care?

    Will Medicare cover hospice care?

    Yes, Medicare covers hospice care and offers a no-cost option for those who qualify. A hospice provider must be Medicare-approved to be covered. There might be a co-pay for prescriptions or other services, but private insurance plans or Medicare supplements can help close any gaps in coverage.

    Do Medicare supplemental insurance plans cover hospice care?

    Yes, Medicare supplemental insurance, or Medigap, will cover the cost of hospice services and other health costs unrelated to a terminal illness. Medigap typically kicks in to cover co-pays, prescriptions, respite care and other expenses not covered by Medicare. With this combination of coverages, 100% of your hospice care costs could be covered with no out-of-pocket expenses.

    Can you get hospice care without insurance?

    Yes, you can get hospice care without insurance. You can pay out of pocket, and some facilities offer services on a sliding scale if you’re unable to afford hospice care. Hospices should have someone on staff who can discuss costs and payment options with you or help you qualify for charitable care with the provider.

    Does insurance cover hospice care at home?

    Most private insurance plans provide coverage for hospice care, including visits or full-time nursing care at home.

    Contact your insurance provider to learn which services are covered and if there are any out-of-pocket costs like deductibles or co-pays for prescriptions, skilled nursing or other services.

    » COMPARE: Assisted living vs. nursing home vs. home care

    When is it time for hospice care?

    The decision to move to hospice is a difficult one to make, but there are a few signs that can help you determine when a loved one is ready. If they’ve had to deal with frequent hospitalizations or infections, rapidly declining health, uncontrollable pain, shortness of breath, nausea or vomiting, hospice care can provide relief and comfort.

    Similarly, if you’ve noticed increased difficulty as your loved one performs daily tasks or a reduction in their appetite, alertness, lucidity or energy levels, it might be time to discuss the need for hospice care with your doctor.

    » MORE: How to find the best hospice care

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      Can I have hospice care in my own home?

      Yes, hospice care can take place in your home, an assisted living facility or nursing home. In-home hospice care is significantly more affordable than inpatient care, and it offers the patient around-the-clock care as long as family and friends can fill in when nurses are away.

      How do I find a hospice program?

      Ask your doctor about highly rated hospice care providers or facilities in your area. You can also research providers in your loved one’s insurance network or find Medicare-approved facilities with good reviews from patients’ families. Once you’ve selected a hospice provider, you can request a tour to see the facility and meet the doctors.

      Can you go to hospice if you aren't dying?

      No, hospice is specifically for those with terminal illnesses and a prognosis of no longer than six months. If your loved one needs care but is expected to recover, they might be a candidate for palliative care, which offers support and comfort at any stage of a serious illness.

      Can you go on and off hospice care?

      Yes, you can end your hospice care at any time. This might make sense if the patient decides they want to try treatment again or if their condition improves while in hospice. You can also remove your loved one from hospice care if you’re dissatisfied with the service they’re receiving. They can begin hospice care again as long as they still qualify through insurance or Medicare.

      When you’re in hospice, can you still go to the doctor?

      Your hospice care team includes doctors, nurses and hospice aides, but you can still see your primary care physician as needed. Medicare and Medicaid patients are required to get permission from the hospice provider before seeing another doctor, however.

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