Hospice care treats the person, not the disease, by managing symptoms so a person’s last days may be spent with dignity and comfort. It is often a family-centered service that includes the patient and the family in making decisions.

Hospice care is provided in a variety of locations: homes, hospitals, nursing homes, and free-standing hospice centers. Most people typically receive hospice care at home, with a family member filling the role of primary caregiver. This is a taxing, 24/7 role, and will require significant work.

Hospice care is provided by a hospice care team or program, normally in tandem with the patient’s primary caregiver (typically a family member). Hospice care is typically started when a patient’s cancer can no longer be controlled, and their life expectancy is less than six months. Accessing hospice care should start as a conversation between the patient (if possible), their primary caregiver, and their healthcare team or physician most closely managing their care. Generally, hospice will become an option once it becomes clear that the cancer can no longer be controlled, therapy is no longer effective, and life expectancy is short.

There are multiple types of hospice care – in home, inpatient, nursing home based, or hospital based. These will vary in price, but generally, should be covered by insurance. Hospice care is covered by Medicare Hospice Benefits, Veteran’s Administration benefits, and may be covered by Medicare benefits, which vary on a state-by-state basis. Private insurance provides at least some coverage for hospice care as well, but each insurance plan will be different. Private insurance may have criteria for who can go on hospice care and specifics about what will be covered. Talk to your insurance provider about what they will and won’t cover.

Generally, hospice care begins when a person is expected to live less than six months. So, typically, the length you will be in hospice care is determined by how long you live after beginning care. Hospice care continues until end of life, and while it is impossible to 100% accurately predict when someone will pass, care will generally not be started until it appears that a patient’s life expectancy is six months or less. If a patient happens to live longer than six months in hospice, they can remain in hospice until the end of their life.

It is possible, however unlikely, that a patient may experience some type of rebound or revitalization while receiving hospice care. In a situation like this, hospice care can be withdrawn and then resumed if life expectancy returns to six months or less.

Hospice at home often requires significant help from a caregiver, normally a family member. Hospice staff can help the caregiver know what to expect moving forward and provide tools and resources.

Hospice staff can help prevent caregivers from feeling like they’re “flying blind” and on their own by providing care plans, information, tips, and strategies to help caregivers manage their role. Staff can also provide a wealth of information and experiential advice, as they are likely much more familiar with hospice situations than the average caregiver.

Inpatient hospice care can offer caregivers and family members some respite from around-the-clock care that is often required at home. In fact, a specific kind of hospice care, called respite care, is designed specifically to provide rest for caregivers, or otherwise takeover when unexpected situations arise, such as caregiver illness.

If a caregiver begins to feel burned out or overwhelmed, it is essential that they share these feelings with the hospice team sooner than later so that the problem can be addressed before it creates a larger issue.

The hospice team will help offer post-mortem care, which may include a bath, removal of tubes and IVs, and a change of clothes. Trained hospice workers can also help coordinate what happens to your body, details for the death certificate, and funeral home coordination.

Hospice workers are also excellent in helping the family emotionally process a passing. Families and cultures handle death differently, and hospice workers will help the family members grieve and prepare for burial.