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Hospice, also called end of life care, is available to help terminally ill people live their remaining days with dignity. These programs can assist the family (or other designated caregiver) in making the patient as comfortable as possible through pain and symptom management. These services are used at the life-ending stage of a serious illness when no further curative or life-prolonging therapy is available or wished to be pursued by an patient or family member.

Hospice care focuses on the patient's end-of-life needs to ensure that they are as comfortable as possible during their last moments. This is different than supportive palliative care which focuses on improving quality of life while still pursuing treatment.

Please note that hospice care for children is different than it is for adults. See the section below for more information.

Is Hospice The Same As Supportive Palliative Care?

Hospice is a type of palliative care that may be offered during the terminal stage of illness when no further curative or life-prolonging therapy is available or when the adult patient or family member does not want to pursue it.

There are many misconceptions about hospice care. To learn more about hospice care myths and facts, visit the HHS hospice page.

Where Are Services Provided?

You can get hospice services in a:

  • Hospice facility
  • Your home
  • Hospital
  • Nursing home
  • Intermediate care facility

How Do I Pay For Hospice Care?

Even though hospice usually costs less than care in a nursing home or other institution, many families still need help paying for it. You may be able to pay for hospice care through your private insurance, Medicaid or Medicare.

Medicaid

If you get Medicaid, you may be eligible for hospice if you meet these conditions:

  • Your hospice doctor and your regular doctor certify that you’re terminally ill with a life expectancy of 6 months or less.
  • You accept care for comfort instead of care to cure your illness.
  • You sign a statement choosing hospice care instead of other treatments for your terminal illness and related conditions.

Medicare

If you have Medicare Part A (hospital insurance) and meet all of these conditions, you can get hospice care:

  • Your hospice doctor and your regular doctor, if you have one, certify that you’re terminally ill with a life expectancy of 6 months or less.
  • You accept care for comfort instead of care to cure your illness.
  • You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.

If you get Medicare, hospice care can be offered at your home. Depending on your illness and related conditions, other services that may be offered include:

  • Nursing care
  • Respite care
  • Social work services
  • Prescription drugs
  • Grief and bereavement loss counseling

What About Hospice For Children?

Unlike adult hospice care, if your child gets Medicaid or is enrolled in the Children's Health Insurance Program (CHIP), he or she may receive curative treatment and hospice services at the same time.

Having the "talk" with your child

End-of-life care is a tough conversation to approach with your child. The Conversation Project's Pediatric Starter Kit is a specific guide for parents wanting to have "the talk" with their ill child. As frightening and as heavy this conversation may be, there are benefits in starting this conversation:

  • Better coping mechanisms
  • Less feelings of regret after having the conversation
  • Stronger family communication skills
  • Better understanding of what your child's wishes and needs are

How Do I Tell My Family About My Decision?

Talking about end-of-life care often is a difficult conversation to have with family members and healthcare professionals.

The Institute for Healthcare Improvement provides a conversation starter kit (PDF format) with a step-by-step guide on how to discuss your end-of-life choices with family and other loved ones. Some suggestions include:

  • Writing down your thoughts and concerns prior to the conversation.
  • Practicing the conversation with a friend.
  • Reasserting what matters to you at the end of life.

For more educational materials on hospice care, visit The Final Acts Project for tools and resources for support and guidance in developing a hospice care plan for you.