Hospice

There is a specific type of palliative care—called hospice—for people for whom a cure is very unlikely and who are likely to have six months or less to live. Hospice care can be provided at a hospice facility, hospital, nursing home or your home.

Hospice care is about giving you control, dignity, and comfort, and providing the best possible quality of life with what time remains Hospice care also provides support and grief therapy for your loved ones.

When to Seek Hospice

So how do you know when it's time for hospice care? Sometimes your doctors or other providers may suggest hospice care as part of your care plan. As a patient, or caregiver of a seriously ill patient, you may ask your care team if hospice care might be helpful to support you our your loved one as serious illness reaches an advanced stage. Requesting hospice care is a personal decision, but it's important to understand that at a certain point, doing various medical treatments may no longer be helping you to gain quality of life or more time that is meaningful to you or your loved one. Sometimes the burdens of a treatment outweigh the benefits.

For instance, an treatment might give you another month of life but make you feel too ill to enjoy that time. Palliative care providers will work with you doctors and care team to help you assess the advantages and disadvantages of specific treatments.

To be eligible for hospice care, your physicians expect you to have limited life expectancy of 6 months or less if your disease runs its usual course. Many patients receive hospice care and live much longer as a result, as treatment of the burdensome symptoms of illness have been shown to extend life.

Even though you or your loved one might benefit from hospice care sooner, unfortunately, most people don't receive hospice care until the final weeks or even days of life, possibly missing out on months of hospice support. This may be out of fear that choosing hospice means losing out on a chance for a cure or missing some types of treatments. Sometimes doctors fear that their patients will feel abandoned if they suggest hospice.

Hospice care may help you continue care that is maintaining or improving your quality of life. If your illness improves, you can leave hospice care at any time and return if and when you choose to.

The following are some signs that you may benefit from hospice care focused on better quality of life with hospice care:

  • You've made several trips to the emergency room, and your condition has been stabilized, but your illness continues to progress.

  • You've been admitted to the hospital several times within the last year with the same symptoms.

  • You wish to remain at home, rather than spend time in the hospital.

  • You are no longer receiving treatments to treat or attempt to cure your disease.

What Hospice Care Can Do for You (All Ages)

  • Hospice care allows you to remain and receive medical care in your own home, if desired and possible.

  • It prevents or reduces trips to the emergency room for aggressive care that you might not want. Although you still might go to the hospital for tests or treatments, hospice allows you and your loved ones to remain in control of your care.

  • Members of the hospice team can clean, cook, or do other chores, giving your loved ones a chance to run errands, go out to dinner, take a walk, or nap.

  • Hospice programs offer bereavement counselling for your loved ones, often for up to a year.

Hospice Care for Children: Special Considerations

Hospice care is also available to children with a limited life expectancy of six months or less if the disease runs its usual course.  Similar to adult hospice care, pediatric hospice care aims to ensure that children and families have the best quality of life possible as the end of life approaches. 

Differences between adult and pediatric hospice care include:

  • Because it is often more difficult to estimate prognosis in children with life-limiting disease than it is in adults, there can be benefit to receiving hospice care simultaneously with treatments intended to cure.  Receiving hospice and cure directed therapy may be an option for your child if she receives Medicaid, or depending on what type of care is covered by your health insurance. 

  • The pediatric hospice team often includes care providers who are specially trained in the developmental needs of children and their siblings. 

  • There are very few hospices exclusively focused on caring for kids.  Most pediatric hospice care is provided by adult hospice agencies that also have experience in caring for children.  

  Hospice Agency Quality Ratings

  • On August 16, 2017 Centers for Medicare and Medicaid Services (CMS) unveiled the new Hospice Compare website. The goal of Hospice Compare is to help consumers compare hospice providers on their performance and assist consumers in making decisions that are right for them. The Hospice Quality Reporting Program (HQRP) was established under section 1814(i)(5) of the Social Security Act. The Act requires the public report, on a CMS website, of quality measures that relate to the care provided by hospice programs across the country

  • Search the Hospice Compare Site: https://www.medicare.gov/hospicecompare/