Hospice Care

Approved by the Cancer.Net Editorial Board, 12/2015

Hospice care is a type of palliative care. Your health care team can include palliative care to help prevent or relieve cancer symptoms. It also helps with treatment side effects. You can have palliative care any time during cancer treatment. This includes when you are getting treatment for a cure.

Hospice care is palliative care that is usually chosen when a cure is not likely or when people are clearly in the last months of life. 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.

However, no one knows for sure how long you (or your loved one) will live. If you receive hospice care and live longer than 6 months, you can continue to get hospice care as long as you qualify.

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 – Your cancer treatment is not working. Or it is not likely to work. You and your doctor have stopped 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 from the National Hospice and Palliative Care Organization.

How does hospice help?

Hospice care helps you and your family cope with the change from fighting cancer to living life as fully as possible through the very end of life.

Hospice care may include:

  • Medication

  • Physical therapy

  • Nutrition therapy

  • Counseling

  • Massage

  • Art or music therapy

  • Support for family members in providing care and grieving after the person dies

Hospice caregivers often give this care in a person’s own home. Or, if needed, a person might come 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 can’t control your care or life plans.

Thankfully, these worries are unnecessary. The information below talks about each concern. You can also talk with your doctor and cancer care team.

What if I get better?

If you get better, you may stop hospice care. This could happen if your cancer improves or goes into remission. If it improves, you and your doctor might start treatment for a cure again. If it goes into remission, doctors will check regularly for signs of cancer. This is because remission means doctors cannot find any cancer. It also means you have fewer symptoms. The doctor will check to make sure the cancer stays in remission.

Is hospice care as good as treatment for a cure?

Most medical care has the goal of curing disease. Hospice care is different. The goal is to help you feel better when a cure is not possible. This can seem “not as good” because you and your doctor are not trying for a cure any more. But the care you receive is still high-quality care.

There are national standards for hospice, just like for hospitals, doctors, and nurses. You can make sure 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 sometimes live longer than people getting regular cancer treatments. This might be because they are more comfortable without treatment side effects. Getting hospice care does not necessarily mean dying sooner.

Can you control your hospice care and life plans?

Yes. You and your hospice team create your care plan together. Your doctor and other health care team members help, too. The plan shows what you want. This includes staying comfortable, eating and drinking, doing activities, and more. You can plan, and you can change the plan over time.

The hospice care team

Your hospice care team is a group of health care professionals who support you and your loved ones. You meet regularly with team members to talk about your health and other needs. Then the team works 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, if you want it

  • 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.

  • Hospice care in other places. The medical name for hospice away from your home is “inpatient hospice care.” You get hospice 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

If you choose hospice in a care center, think about:

  • Where the care center is – Is it convenient for family and friends? Can they visit any time?

  • Is it peaceful, quiet, and private?

  • What does it cost?

  • Who gives most of your care? Can family or friends help?

Finding hospice care

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

  • Your cancer care team

  • A discharge planner 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?

  • If you choose to have hospice in a care center – Can my family and friends visit any time?

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 or you and your family

  • Nutrition counseling

Medicare does not cover:

  • Treatments for the cancer or other diseases that are causing your illness, except treatment 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. However, policy benefits differ from insurer to insurer. Talk with a hospital social worker, who can help you understand your options.

More Information

Advanced Cancer

Advanced Cancer Care Planning

Coping with Cancer 

Additional Resources

National Cancer Institute: Hospice Care

American Hospice Foundation

National Association for Home Care & Hospice

Hospice Education Institute

National Hospice and Palliative Care Organization

International Association for Hospice & Palliative Care