Hospice care provides comfort-focused medical care, pain management, and emotional and spiritual support for people with a terminal illness when the prognosis is 6 months or less if the disease follows its normal course. It shifts the goal from curing to quality of life.
10 steps across 1 sections
1. Steps Guide
- Understand what hospice is and is not — Hospice is not giving up; it is choosing comfort and quality of life. It does not hasten death. Patients can revoke hospice at any time and return to curativ...
- Recognize the signs it may be time — Consider hospice when: repeated hospitalizations occur, treatment is no longer effective, the patient declines food or fluids, there is significant functional d...
- Discuss wishes with the patient — If possible, have an honest conversation about goals of care, fears, pain management preferences, and where they want to spend their final time. Respect their auto...
- Get a physician referral — The patient's doctor or a hospice medical director must certify a prognosis of 6 months or less. Ask the doctor directly: "Would you be surprised if this patient died in ...
- Research hospice providers — Use Medicare's Hospice Compare tool to evaluate local providers. Ask about services offered, staffing, response times, volunteer programs, bereavement support, and accr...
- Understand the 4 levels of hospice care — Routine home care (most common), continuous home care (crisis management), inpatient respite care (caregiver relief, up to 5 days), and general inpatient c...
- Choose a hospice provider — Interview at least 2-3 providers. Ask about nurse visit frequency, 24/7 on-call availability, average response time for urgent needs, and what happens if needs exceed ho...
- Designate a primary caregiver — If hospice will be at home, identify who will provide daily care between hospice team visits. Discuss backup plans and respite options.
- Complete advance directives — Ensure a living will, healthcare power of attorney, and DNR/POLST forms are completed and accessible. Discuss code status preferences.
- Prepare the home — If receiving care at home, the hospice team will deliver a hospital bed, medications, oxygen, and other equipment. Clear space, ensure accessibility, and set up a comfortable car...
Common Mistakes
- Waiting too long to start hospice
- Confusing hospice with palliative care
- Assuming hospice means only a facility
- Not asking enough questions
- Believing hospice hastens death
Pro Tips
- Use Medicare Hospice Compare
- Know that hospice can be revoked and re-elected
- Ask about the hospice team composition
- Understand what medications are covered
- Request a pre-hospice consultation