Hospice Care

Approved by the Cancer.Net Editorial Board, 09/2019

Hospice care is a type of care used when a cure is not likely or when people are in the last months of life. It is used by your health care team to provide palliative care, or supportive care, to help prevent or relieve cancer symptoms. It also helps with treatment side effects. You can receive this care any time during cancer treatment. This includes when you are getting treatment for a cure. Hospice care prevents and relieves symptoms and helps you live the rest of your life as well as possible.

Does hospice care mean I have a certain time to live?

Not necessarily. This idea comes from Medicare, the U.S. government organization that pays for much of older Americans’ health care. Medicare pays for hospice care if your doctor believes you have 6 months or less to live, the cancer does not respond to treatment, and your medical condition does not improve.

But no one knows for sure how long you will live. If you receive hospice care and live longer than 6 months, you can continue to get hospice care as long as you still meet the Medicare requirements.

The information below tells you more about Medicare, Medicaid, and private insurance payments for hospice.

Who qualifies for hospice care?

You or your loved one may get hospice care if:

You are in the last stage of life. This is when cancer treatment is not working or it is not likely to work. It is when you and your doctor are no longer trying to cure the cancer.
The doctor believes you are likely to die in the next 6 months if your medical condition runs its natural course.

Get the facts about hospice care from the National Hospice and Palliative Care Organization.

How does hospice care help?

Hospice care helps you and your family cope with the change from treating the cancer to living life as fully as possible through your final days.

Hospice care may include:

Nurse visits at your home for checkups
Home health aides to help with bathing and other routine care needs
Equipment needed to keep you comfortable, such as a hospital bed, oxygen, walker or wheelchair
Social work
Chaplains for spiritual support
Medications to help maintain your comfort
Physical therapy
Nutrition therapy
Counseling
Massage
Art or music therapy
Support for family members in providing care and grieving after the person dies

The hospice care team often give this care in a person’s own home. Or, if needed, a person might go to a special hospice center or other health care center.

Some people have the following concerns about hospice:

Hospice care is not as good as curative cancer treatment.
People die sooner in hospice than if they have curative cancer treatment.
In hospice, you cannot control your care or life plans.

The information below talks about each concern to help relieve your worries. You can also talk with your health care team.

What if I get better?

If you get better, you may stop hospice care. This could happen if the cancer improves or goes into remission. Remission is when the cancer cannot be detected in the body and there are no symptoms. If the cancer improves, you and your doctor might start treatment again for a cure. This is very uncommon. But if treatment is started, the goal is usually to relieve symptoms that the cancer is causing. In most cases, it would be unlikely for the treatment to lead to a cure.

If the cancer goes into remission, your doctor will check regularly for signs of cancer to make sure that it stays in remission.

Is hospice care as good as treatment?

Most people hope for a cure when first diagnosed with cancer. Hospice care is different. The goal is to help you feel better when a cure is not possible. This can often make people feel much better when harsh treatments are stopped and symptoms are treated more aggressively. Most people feel better and can live longer when they start hospice care earlier. Hospice care can help people achieve their personal goals, such as spending less time at the doctor’s office and more time with loved ones.

There are national standards for hospice care, just like there are for hospitals, doctors, and nurses. You can make sure that you choose hospice care that meets high standards.

Do people die sooner in hospice?

This idea is understandable, because stopping treatment for a cure might seem like giving up. But cancer treatment is hard on your body. People in hospice care often live longer than people with advanced cancer getting regular cancer treatments. This might be because they feel more comfortable without the treatment side effects. So, getting hospice care does not necessarily mean dying sooner. It may even help you live longer.

Can you control your hospice care and life plans?

Yes. You, your hospice care team, and your health care team create your care plan together. The plan shows what you want. This includes staying comfortable, eating and drinking, and doing activities. You and your health care team can update the plan over time based on how you are feeling and how your goals change.

The hospice care team

Your hospice care team is a group of health care professionals who support you and your loved ones. You will meet regularly with the team to talk about your health and other needs. Then the team will work with you and your family to make or update your care plan. Working together helps you get the care you want and need.

Besides these meetings, you can call your hospice team any time. Someone is available 24 hours a day, 7 days a week.

Your hospice team might include:

Doctors that supervise your care from other hospice team members
Nurses and home health aides
Social workers and counselors
Chaplains for spiritual help and advice
Therapists, such as physical therapists, occupational therapists, and rehabilitation therapists
Dietitians to help with nutrition
Volunteers who are trained to give hospice care

Where you get hospice care

You usually get hospice care at home. Other options are a care center, such as a nursing home, or a special hospice center. Some people even have hospice care in a hospital.

The information below tells you more about hospice at home and in other places.

Home hospice care. A family member or close friend usually does most of your care. Hospice team members come to your home to help. For example, they might help you eat or take a shower. Or they might help with medicines. They can also come to your home to give your primary caregiver a chance to take a break.
Hospice care in other places. The medical name for hospice care away from your home is inpatient hospice care. This means you get hospice care at a nursing home, hospice center (sometimes called a hospice house), or other place. If you want this type of hospice, find a place where your family and friends can visit easily.

Choosing a place for hospice care

Consider these questions when deciding on a hospice center:

Is it convenient for family and friends? Can they visit any time?
Is it peaceful, quiet, and private?
What does it cost?
Who provides most of your care? Can family or friends help?

Finding hospice care

When you decide to have hospice care, ask for help finding care. You can ask:

Your health care team
A discharge planner or social worker at your hospital
Websites of hospice organizations in your area
The local health department. They may have a list of licensed hospice care providers

Questions to ask the hospice team

Before you decide on a hospice team, you might want to ask these questions:

How will you help with my pain and other symptoms?
How will family members help with my care? For example, feeding, bathing, giving medication, and keeping track of my health.
Do you help with the emotional part of dying? The spiritual part?
Who can my family call with questions?

Medicare and hospice

Medicare is health insurance from the U.S. government. It is for people 65 and older. It also covers some people with disabilities.

Medicare will pay the costs of hospice in a program they approve. Your doctor needs to sign a form saying you are likely to live 6 months or less if your medical condition runs its natural course. But hospice care can continue if you live longer.

Hospice services that Medicare covers

Medicare pays for the services below, usually in your home:

Care from a doctor
Visits or care from a nurse , including 24-hour on-call services
Supplies for your illness. For example, a brace, walker, or hospital bed.
Medicines for pain and other symptoms. You might need to pay a small amount. But Medicare usually pays for the rest.
Short-term care for your symptoms. If you go to a place Medicare approves, such as a Medicare-approved hospital.
Short-term care in a care center so your main caregiver can rest. The medical term for this is respite care. You might need to pay a small amount.
Services from a home health aide or housekeeper
Counseling and spiritual support, including help with grief for you and your family
Nutrition counseling

Medicare does not cover:

Treatments for the cancer or other diseases that are causing your illness, except medicines to help symptoms
Care that is not from the Medicare-approved hospice program

Learn more about the Medicare hospice benefit.

Medicaid and hospice

Medicaid is health insurance from your state. It pays the cost of care for people with low incomes and certain disabilities. It also pays for some people in families with young children and some older people.

Learn more about the Medicaid hospice benefit.

Private health insurance and hospice

Most private health insurance plans cover hospice services. But policy benefits are different for each insurer. Talk with a hospital social worker, who can help you understand your options.