Hospice Care: Quality of Life at the End of Life

There are many different types of care and treatment that are available when you or a loved one is diagnosed with cancer. However, when treatment is no longer of benefit, or there are no further treatment options available, your doctor may speak to you about hospice care. Hospice offers care to people who are terminally ill and may no longer wish to undergo treatment. The focus of hospice care is to ensure quality of life at the end of life by addressing a person’s physical, emotional, and spiritual well-being. This fact sheet answers some commonly asked questions about hospice care.

Who provides hospice care?

Hospice care can be provided by members of a person’s health care team:

• Primary care physicians and hospice nurses, who have been specially trained to meet the medical needs of a person who is facing a terminal illness

• Oncology social workers, who provide emotional support and counseling and may specialize in end-of-life care

• Chaplains and spiritual advisors, who provide guidance and support surrounding spiritual concerns

• Home health aides, who can assist with practical tasks such as bathing or dressing

• Volunteers who can help with day-to-day tasks such as grocery shopping or housekeeping

What services are offered?

The various members of your hospice team may provide:

• Medication to relieve the discomfort caused by nausea, pain, or shortness of breath.

• Medical supplies and equipment such as oxygen, a hospital bed, or a walker.

• Emotional support.

• Spiritual support.

• Respite care, which can provide a short-term break for the caregiver and family.

• Assistance with day-to-day tasks of caring for a person receiving hospice care.

• Bereavement counseling to the family members of the loved one.

Where is hospice care provided?

Hospice care often takes place in a person’s own home. However, it can also be given in settings such as a nursing home, hospital, or a medical center specifically for people receiving hospice care.

Who decides about hospice care?

Your health care team will often begin the discussion surrounding hospice care. If your doctor has not spoken to you about hospice and you feel it should be discussed, then it is important that you and your loved one begin the conversation. Keep in mind, though, that talking about hospice care does not mean that you have “given up.” Instead, starting the conversation about hospice care will only ensure that you or your loved one receives the best quality of care and attention at the end of life.

How do I find a hospice provider?

The members of your health care team, which includes doctors, nurses, social workers, or discharge planning coordinators at a hospital or treatment center, can refer you to a hospice provider. You can also search for a hospice in your area by visiting www.hospicedirectory.org, or by calling 4-1-1 for free directory assistance.

Who pays for hospice care?

Many, but not all, health insurance plans cover the cost of hospice care. Some plans offer a per diem rate for hospice care; others pay on a fee-for-service basis. There may also be a cap on how much the insurance will cover. The Medicare Hospice Benefit pays for most hospice services for patients who are covered under Medicare Part A. Most state Medicaid programs pay for hospice services as well—visit www.hospicedirectory.org to see if your state offers Medicaid-certified hospice care.