Here are the responses to some of the questions most frequently
asked about hospice. If you don’t see an answer to your
question, I invite you to email me (link to email) and I will
directly to you or post the response on the website -- without
mentioning any names, of course.
Q: What is Hospice?
A: Hospice is a quality of life enhancing option for those who
are no longer responding to medical treatment and who the doctor
believes have six months or less to live.
Hospice care is most often delivered at home and its focus is
relieving pain and discomfort, not cure. Modern technology has
made it possible for hospice patients to resume their fairly
normal routine for much of the course of the illness. When the
illness progresses to a point where the patient is bedridden,
palliative care can significantly reduce or, in some cases, eliminate
For more information on the origins of hospice and specifics
on how hospice works, see our Report #1
Understanding Hospice Care.
Q: Is Hospice Expensive
A: In most cases Hospice is covered by Medicare. You can check
with the insurance commission in your state to find out if
this applies to your situation.
Q: What should I look for in a hospice provider?
A: Not all hospices are alike. So the most important thing you
can do is make sure you have the best information to evaluate
your needs with what the hospice provides. Having said that,
here are some key things to look for:
- Size of staff. In addition to the case manager, nurses,
doctors, medications, and social workers, which all hospices
must have, ask if they have a full time clergy person, a
robust volunteer program, a registered dietician. You can also
such specialties as music therapy and an ongoing bereavement
- Continuity of care: Will you see the same people throughout
the program or will you have a different nurse each visit.
- Personal care: What is the extent of
care they provide, i.e. how many times a week will the case
manager visit? How
about the bath nurse? How often will you see the doctor? In
situation you can expect to see the case manager at least once
a week, the bath nurse 2-3 times a week and the doctor—who
you may see only rarely—should be available when you
do need him/her. (Keep in mind that the doctor is not there
your loved one, their job is to make sure the symptoms are
being managed properly. This does not require frequent visits
your case manager should be constantly communicating with the
- Can you call the hospice provider 24 hours a day for
advice. Once you settle in with the hospice routine, you
should not need to be calling the provider very often. However,
do have some sort of emergency, you want to be sure there
will be someone available to help you.
Several of our reports provide more in-depth understanding of
what to look for in selecting a hospice provider. We invite you
to look over our titles to assist you in determining whether
you need more information.
Q: If I choose Hospice, what do I have
to do to make my home ready?
A: There are a number of things you can
do to make you home more patient-friendly. The main thing is
to keep it homey.
You are not turning your home into a hospital, you are creating
a place that is familiar for the patient and welcoming to those
who may come by to visit.
Even with that in mind, there is special equipment, from beds
to medical devices that can make home care easier for the care
giver and more comfortable for the patient. Obviously this is
a fairly in-depth question and your hospice care provider can
a broader view with specific suggestions that may give you an
even broader perspective of what’s
available than your hospice provider may mention, refer to
Report #R-10002, How to Prepare
Your Home for Hospice Care.
Q: Is it possible to know how much time
my loved one has left?
A: There is no way to know exactly how much
time is left. The reason the patient has been referred to hospice
is that, in
the best estimate of the physician, if the disease runs its
normal course, there is less than six months. In my experience
when you start focusing on symptom control rather than fighting
the disease, it’s not uncommon for the patient to exceed
the six-month prognosis.
Q: How can I know if the end is near?
A: There are signs that the body is shutting
down and you can generally know when it is down to days or possibly
Beginning signs are loss of appetite (because the body simply
doesn’t need as much food any more as it shuts down),
increased time spent sleeping, loss of interest in what’s
going on in the world -- like not caring to watch TV.
This subject is covered in greater detail in Report
#R-10003, How to Care for the Dying Patient and Control End of
Q: What might I expect from my loved one
if we choose hospice?
A: Consider that patients who are receiving
aggressive forms of treatment often find that much of their discomfort
resulting from the treatment, not the illness. We can’t
say what might happen in your particular situation, however
we can report that often there is a profound improvement in
the way the patient feels as the focus of the care turns to
eliminating or reducing symptoms. Often energy returns, outlook
brightens, and almost normal life can be resumed for a time.
Report #R-10003, The Gift
of Hospice, has several
stories of how people’s
lives have changed once they went on hospice care.
Q: If the doctor recommends hospice does
it mean there is no hope?
A: When a doctor recommends hospice it means that the options
he or she is aware of are not producing the results that indicate
the patient is moving toward cure. Some doctors arrive at this
conclusion earlier than others simply because some doctors believe
they must fight the disease to the very end.
When a doctor recommends hospice care, the bottom line is that
he or she believes that the patient has six months or less to
Have there been cures after patients have
gone on hospice? That is always a possibility. However, cure
is not the intention of
hospice—having good, maybe even almost normal, quality
of life for as long as possible is the focus of hospice. And,
at the very end stages, hospice focuses on making the transition
as easy as possible.
Q: Does hospice provide someone to be with
a patient 24/7?
A: Although hospice provides regular care, day-to-day care is
up to family or friends. If the family can afford it, you can
hire private duty nurses or care givers for as much extra support
as you want. However, you may be surprised to find how much
you can do without a professional care giver as long as you
have the proper information. Having said that, do arrange with
family and friends to give the primary care giver (often a
spouse or adult child) a break from time to time. Especially
in the end stages, the patient may need more care -- that is,
more attention. So it will serve you to line up your support
so you can conserve your energy and have minimal stress.
Q: If I choose hospice, can I change my
mind and return to a treatment program?
A: Absolutely. Usually a phone call will put the switch into
motion and the process can easily be completed within a day or
so. In addition, if you later choose to return to hospice, you
can do that with similar ease.
All content on this website and in our reports is intended
for information purposes only. Always consult your medical
practitioners for medical advice.