Hospice provides comfort and support to people nearing the end of life. It helps them and their family let go with dignity. Hospice focuses on quality of life. And it helps the person live their last days or months with a sense of control. Hospice programs support both the person and their family. They include physical, emotional, and spiritual services. This sheet tells you more about hospice. It may help you decide if this care is right for you or your loved one.

Hospice is a special type of care for people who are ill and are expected to have 6 months or less to live. Its goal is not to make life shorter or longer. Instead, the goal is to give comfort and support to a dying person and their loved ones. Hospice care helps to ease disease symptoms such as pain, upset stomach (nausea), and breathing problems. But treatments to cure the person's illness are stopped. Hospice also helps to meet the emotional and spiritual needs of the dying person and their family and friends.

A person with a life-limiting illness can go into hospice when a doctor believes they have about 6 months or less to live. Hospice care can be used by people in the end stages of cancer, severe lung disease, heart failure, and other diseases. Hospice continues as long as it's needed. If a person's health gets better, they can end the hospice care and start it again later. The person also has the right to leave hospice care at any time for any reason.

Hospice is most often provided in the home. It can also be offered in a nursing home, assisted living facility, or hospital. It depends on the person's care needs. Hospice care is provided by a health care team that includes doctors, nurses, and other health care providers. A registered nurse case manager (RN case manager) coordinates care given by the hospice team. The team includes the hospice doctor and the person's personal doctor. They also provide skilled nursing care as needed. The RN case manager makes visits no less than every 14 days and more often as needed to meet the needs of the client and their family. Hospice also offers access to other providers. These include:

• Social worker.
• Home health aide.
• Counselor.
• Chaplain or other spiritual advisor.
• Other providers, as needed.

If hospice is done at home, family members give day-to-day care. Hospice support is given to the person and their family in many ways. It may include:

• Making sure medicines are given for the person's comfort.
• Providing ongoing evaluations and care adjustments based on the person's comfort needs.
• Helping the family set up the home.
• Teaching the family about their loved one's medicines, how to give them, and how to provide physical care.
• Supplying medical equipment as needed.
• Helping the family arrange 24-hour care.
• Helping the person and family find emotional, spiritual, and financial resources.
• Managing contact between the person, family, and health care providers.

Help for loved ones in mourning (bereavement care) must be available for a year after the person's death.

Here are answers to some common questions about hospice care:

• Where is hospice provided? Hospice is a method of care. It's not a physical location. It may be offered in the person's home, a nursing home, a hospital, a hospice facility, or in another place. Respite care allows family to have a few days off from their care responsibilities. Their loved one would be admitted short- term to one of the hospice-designated facilities for those days.
• Does hospice only offer one type of treatment? People in hospice care receive treatments and interventions to give them the most comfort and quality of life. In some cases, they may have the same treatments they received before hospice. This can include palliative chemotherapy, radiation, and heart failure treatments. People can also come and go from hospice at any time. Once a person leaves hospice, they may come back to the program at any time if they qualify, for instance, if their doctor finds that they only have 6 months or less to live.
• Can anyone who is ill receive hospice care? A person must have about 6 months or less to live to receive hospice.
• Do people need a "Do not resuscitate" (DNR) order to receive hospice? In the U.S., people are not legally required to have made DNR arrangements to have hospice care. People must be informed that taking part in hospice is a choice to accept that death is coming. Aggressive life-sustaining treatments aren't part of hospice. These treatments include ventilator therapy, intensive care, and vasopressors.
• What happens if the person lives longer than 6 months? About 1 in 10 people in hospice care live beyond the 6-month limit. When this happens, the hospice staff may discharge the person. If the doctor continues to certify that the person is still close to dying, Medicare can continue to pay for hospice services.
• Does hospice care shorten a person's life or bring about death? No. In fact, people in hospice care have been shown to live longer than people with similar illnesses who don't use hospice.
• Can someone in hospice still keep their primary doctor? Yes. The primary doctor still plays an important role in the person's care.

Medicare and Medicaid cover hospice care for people age 65 or older. Most health insurance companies also cover it. Hospice may be available at no extra charge as a free benefit. Talk with your doctor to learn more about hospice services in your area.