Table of ContentsView AllTable of ContentsAdvantagesDisadvantagesMisconceptions
Table of ContentsView All
View All
Table of Contents
Advantages
Disadvantages
Misconceptions
Hospice services are a specialized form of medical care that seeks to provide comfort and maintain a patient’s quality of life (to the greatest extent possible) for those facing a life-limiting illness, disease, or terminal condition.
While this care generally attempts to provide holistic comfort and dignity as death approaches, hospice might or might not be the right choice for you or a loved one depending on your unique needs and/or situation.
Here are some of the possible advantages and disadvantages of hospice care to consider.
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Palliative Care vs. Hospice CarePalliative care and hospice care are both intended for those with serious illness, but there are differences between them. Anyone can receive palliative care regardless of their prognosis, while hospice care focuses on comfort care in the terminal phase of the illness. Those under palliative care can also continue to receive curative treatment for their illness, which is typically discontinued when transitioning to hospice care.
Palliative Care vs. Hospice Care
Palliative care and hospice care are both intended for those with serious illness, but there are differences between them. Anyone can receive palliative care regardless of their prognosis, while hospice care focuses on comfort care in the terminal phase of the illness. Those under palliative care can also continue to receive curative treatment for their illness, which is typically discontinued when transitioning to hospice care.
What’s the Difference Between Palliative Care and Hospice?
Hospice provides palliative care, meaning that it addresses the physical, psychological, and spiritual needs of people with serious and terminal illnesses. Rather than simply addressing one’s medical condition, hospice care aims to improve a person’s quality of life.
Hospice includes comprehensive, interdisciplinary care from a team of professionals and hospice volunteers. This care can involve physicians, case manager nurses,home health aids,certified medical social workers, chaplains, and trained hospice volunteers to meet the needs of the patient and his or her family members or personal caregivers.
Care is available 24 hours a day, including weekends and holidays. Patients and their family members or personal caregivers always have access to hospice professionals when they need assistance.
Hospice provides support for caregivers.Aside from nurses, hospice does not provide patients with personal caregivers. They do, however, work closely with a patient’s primary caregiver when making decisions about the patient’s care.
Choosing hospice usually results in a reduction in your out-of-pocket expensesfor medications, durable medical equipment, andmedical supplies. Medicare, Medicaid and/or your private insurance typically cover the cost of these necessary items for hospice patients.
Choosing hospice care can also mean avoiding unwanted hospitalizations, medical treatments, and procedures. The goal of the entire hospice team is to support the wishes of the patient and his or her family members and personal caregivers while helping them achieve their goals for care.
Hospices provide help with medical and non-medical needs. Hospice addresses the spiritual and psychological needs of patients and their caregivers. Spiritual advisors, grief counselors, and social workers trained in addressing emotional needs are often offered at hospice centers.
Hospices commonly offer both home or inpatient care.Since hospice care aims to improve quality of life, many hospices offer hospice care in the comfort of the patient’s own home. Many hospices will also deliver any specialized equipment or medications required to the patient’s residence.
A Word From VerywellI find it is often very helpful to involve palliative care early in a terminal illness. The palliative care team looks at illness through a special lens and focuses on comfort and quality of life. When/if it becomes time to transition to hospice, it is often with the same team that has been providing the palliative care, so it is a continuation of familiar faces in a time when familiarity is so important.—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
A Word From Verywell
I find it is often very helpful to involve palliative care early in a terminal illness. The palliative care team looks at illness through a special lens and focuses on comfort and quality of life. When/if it becomes time to transition to hospice, it is often with the same team that has been providing the palliative care, so it is a continuation of familiar faces in a time when familiarity is so important.—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
I find it is often very helpful to involve palliative care early in a terminal illness. The palliative care team looks at illness through a special lens and focuses on comfort and quality of life. When/if it becomes time to transition to hospice, it is often with the same team that has been providing the palliative care, so it is a continuation of familiar faces in a time when familiarity is so important.
—NICHOLAS R. METRUS, MD, MEDICAL EXPERT BOARD
A potentially significant disadvantage of choosing hospice care might arise due to the restrictions placed on the various aspects of treatment. Under the Medicare hospice benefit, a hospice receives a flat per-day amount of money from whichallmedical expenses must be paid. This can result in several difficulties:
Criteria for when hospitalization is allowed once a patient enters hospice care may be unclear.While theMedicare hospice benefitdoes contain provisions for short-term hospital stays (calledinpatient care) for symptom management, the criteria for admission and coverage for specific treatments are poorly defined.
Participation in experimental treatments or clinical trials is limited, even if you are considered eligible. Your current physical or mental state and and ability to travel can affect your ability to participate in a trial or experimental treatment. In addition, other treatments or procedures considered life-prolonging, like anasogastric or “feeding” tube, might not be part of a patient’s care.
Insurance may not fully cover hospice care for all people. Most hospice patients are eligible for 100% hospice coverage under Medicare. There can be exceptions, however. For example, if a hospice patient goes directly to the hospital without making arrangements with their hospice team, their hospice benefits could be at risk for termination.
Hospice care is not always available. Unfortunately, hospices often have to turn away patients due to a lack of hospice beds. Since hospice is only covered when a medical prognosis gives a patient six months or less to live, it can be difficult to allocate hospice care on short notice.
Families and caregivers often feel guilt for choosing hospice care. It’s common for people to feel guilty when they place their loved one in hospice care, as though they have “given up” on them. Such feelings can make coping with the potential loss of their loved one’s life especially difficult.
What Is Usually Not Included in Hospice Care?Hospice care programs do not provide curative or life-prolonging treatments, such as chemotherapy or organ transplants. Hospice also does not cover room and board fees for hospice care administered in a separate facility, such as a nursing home.
What Is Usually Not Included in Hospice Care?
Hospice care programs do not provide curative or life-prolonging treatments, such as chemotherapy or organ transplants. Hospice also does not cover room and board fees for hospice care administered in a separate facility, such as a nursing home.
Why Do People Not Choose Hospice?
Because manymisconceptions about hospiceexist, as well as a general lack of awareness of its benefits and services, many patients fail to enter hospice at all, which leads to the underutilization of this specialized form of medical care.
Common misconceptions that stop people from referring themselves or a loved one to hospice include:
Hospice care is seen as giving up:Many people feel that hospice care is only about death and preparing to die. This belief causes many people to feel scared about hospice, as though it is a place where people are simply “waiting to die” rather than receiving palliative care to improve their quality of life.
Hospice is for people whose death is hours or days away: Hospice care can be accessed up to six months before a person is expected to die. Many hospices also provide opportunities for extended care. Also, research shows that hospice patients tend to live longer than patients with similar conditions who do not receive hospice care.
Once a person enters hospice care, they cannot leave: Hospice care is entirely at will. If a patient decides that they no longer wish to receive hospice care, they are free to leave without penalty. Should they decide to re-admit themselves to hospice, re-enrollment is typically permitted so long as they are still medically eligible.
Hospice requires a DNR (Do Not Resuscitate) order: The goal of hospice is to provide patients with the comfort and care they need to experience a peaceful death. A DNR is the patient’s decision. Even if you do not sign one, you can still receive hospice care.
Hospice care is only for the elderly: Hospice care is available for any person of any age who has received a prognosis of six months or less to live.
Summary
The pros and cons of entering hospice can vary for you or a loved one depending on yourunique needsand/or situation. When considering hospice, keep in mind that hospice does not include treatments aimed at curing an illness or prolonging life. The focus of hospice care is to provide pain and symptom management, allowing patients to experience a comfortable, peaceful death.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Aging.What are palliative care and hospice care?
Shalev A, Phongtankuel V, Kozlov E, Shen MJ, Adelman R, Reid MC.Awareness and misperceptions of hospice and palliative care: A population-based survey study.Am J Hosp Palliat Care. 2018 Mar;35(3):431-439. doi:10.1177/1049909117715215
National Hospice and Palliative Care Organization.Hospice Care.
American Cancer Society.Where Is Hospice Care Provided and How Is It Paid For?.
Crossroads Hospice.Paying for hospice care.
Medicare.gov.Hospice care.
National Cancer Institute.Choices for Care When Treatment May Not Be an Option.
U.S. Department of Health and Human Services - Office of Inspector General.What is hospice care?.
Eichelberger T, Shadiack A.Life expectancy with hospice care.Am Fam Phys. 2018;97(5).
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