Hospice Decision Guide

The Focus

Hospice is a specialized type of medical care that focuses on providing comfort, managing pain and symptoms, and supporting patients and families at the end of life.

The Philosophy

Rather than trying to cure an illness, hospice care emphasizes quality of life and dignity during a patient's final months. It's not about giving up—it's about shifting focus from fighting disease to living fully.

Life expectancy of 6 months or less

A doctor has indicated this prognosis based on the patient's condition and trajectory. This is the primary medical criterion for Medicare/hospice eligibility. The 6-month estimate doesn't need to be exact—it's a physician's medical judgment about whether the patient is likely to decline.

Patient has declined curative treatment or reached natural endpoint

The patient has chosen to focus on comfort rather than pursuing aggressive medical interventions. Or curative options have been exhausted and disease continues to progress despite treatment.

Focus shifted to comfort and quality of life

The primary goal is now managing symptoms and maintaining dignity, not extending survival. The patient and family understand and accept this shift in care philosophy.

Patient and family understand hospice goals

Everyone is aligned on what hospice care provides and what the expectations are. Honest conversations about prognosis, goals, and what hospice will and won't do are essential.

Physical and/or functional decline is evident

Signs include declining appetite, increased weakness, difficulty with activities of daily living, mental changes, or recurrent hospitalization. These indicate the disease is progressing.

Myth: Hospice means giving up

Hospice is an active, supportive form of care that helps patients live as well as possible during the time they have remaining.

Myth: Hospice hastens death

When used appropriately, hospice doesn't shorten life. The focus on comfort may actually help patients live more peacefully.

Myth: Hospice is only for cancer

Hospice is appropriate for many conditions including heart disease, COPD, dementia, and other terminal illnesses.

Myth: Hospice is very expensive

Medicare and most insurance plans cover hospice care. Out-of-pocket costs are typically minimal.

Expert Symptom Management

Specialized care team trained in pain and symptom control with 24/7 availability. Medications and treatments are adjusted as needed to keep the patient comfortable. Most patients report better pain control in hospice than in hospital settings.

Family Support & Respite Care

Counseling, respite care (short-term inpatient stays), and grief support for entire family throughout and after care. Family caregivers get professional support and relief from round-the-clock caregiving demands.

Care in Your Preferred Location

Most hospice care happens at home, but can also be in a facility, nursing home, or inpatient hospice setting based on patient needs and preferences. Flexibility allows care setting to change if circumstances shift.

Spiritual & Emotional Support

Chaplains and counselors to support personal values, beliefs, and end-of-life goals. Spiritual care is offered across religious traditions and to secular patients, addressing meaning-making and existential concerns.

Comprehensive Care from an Interdisciplinary Team

One care team coordinates across doctors, nurses, home health aides, social workers, and chaplains. This prevents fragmented care and ensures holistic attention to patient and family needs.

Bereavement Support After Death

Most hospices provide grief counseling and support groups for 12-13 months after the patient's death. This helps families process loss and begin healing in the months following death.

Choose the Right Time and Place

Find a quiet, private moment when everyone is calm and there are no distractions.

Listen First

Ask about your loved one's fears, wishes, and values about end-of-life care before sharing information.

Share Information Gently

Explain hospice as a choice focused on comfort and quality of life, not as giving up.

Involve the Doctor

Ask the doctor about hospice as an option and what they recommend for your loved one's situation.

Take Time to Decide

There's no need to rush. It's okay to take time to think about the decision with family.

Talk with your doctor

Discuss your loved one's condition, prognosis, and whether hospice is appropriate for their situation.

Get a hospice referral

Your doctor can refer you to a hospice provider, or you can explore options yourself.

Interview providers

Use our provider comparison framework to evaluate options and compare them side-by-side.

Learn about costs

Check out our cost and insurance guide to understand coverage and financial implications.

Make your decision

Take time with family to make the right choice for your situation. There's no rush.