7 Things to Consider Before Starting Hospice Care
Hospice care is an important option for those facing a terminal illness and looking to prioritize comfort and quality of life in their final months. It’s also something that many people don’t start considering until long after hospice could have—or should have—been started. Whether you’re exploring hospice care for yourself or a loved one, understanding what it involves and what to expect can make the transition smoother and more meaningful. This article offers answers to common questions surrounding hospice care, gives you an idea of what to expect from hospice, and offers some suggestions on what to consider before starting hospice.
What is the purpose of hospice care?
The purpose of hospice care is to provide comfort, dignity, and support during the final stages of life. Rather than focusing on curing an illness, hospice emphasizes quality of life—managing pain, relieving symptoms, and addressing emotional, spiritual, and practical needs. It's a whole-person approach that supports both the individual and their loved ones, ensuring no one has to face the end of life alone or unsupported. Hospice care can be a powerful tool for helping families say goodbye with peace and compassion.
What is the difference between palliative care and hospice care?
Palliative care and hospice care both prioritize comfort, but they serve people at different stages of illness. Palliative care can begin at any point in a serious illness—even alongside curative treatment. It focuses on relieving pain and symptoms and improving quality of life, regardless of prognosis.
Hospice care, on the other hand, is specifically for individuals who are nearing the end of life—typically with a prognosis of six months or less if the illness runs its expected course. At this stage, treatments aimed at curing the disease are usually stopped, and the focus shifts entirely to comfort and support. In short:
- Palliative care = comfort at any stage
- Hospice care = comfort at the end of life
What is in-home hospice care?
In-home hospice care brings medical, emotional, and spiritual support directly into the person’s home—whether that’s a private residence, assisted living facility, or nursing home. A hospice team typically includes nurses, doctors, aides, social workers, chaplains, and volunteers who visit regularly to provide care and guidance.
In-home hospice allows the individual to spend their final days in a familiar, comfortable environment surrounded by loved ones. It can ease the burden of logistics and provide families with the tools and support they need—like equipment, medications, and 24/7 phone access to a nurse—so they’re not navigating this time alone.
What to expect with hospice care
Starting hospice care can feel overwhelming, especially if you're not sure what it actually includes. Understanding what hospice provides can bring a sense of relief and clarity during a difficult time. Here’s a brief overview of what to expect:
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A focus on comfort, not cure: Hospice care shifts away from treatments aimed at curing illness and instead focuses on relieving pain, managing symptoms, and improving quality of life.
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A full care team that comes to you: A team of professionals—including nurses, aides, social workers, chaplains, and volunteers—provides in-home visits and support based on your needs and schedule.
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Personalized care plans: Each person receives a care plan tailored to their specific medical, emotional, and spiritual needs, with adjustments as conditions change.
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Support for the whole family: Hospice isn’t just for the person who is ill—families and caregivers receive education, emotional support, respite care, and grief counseling.
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Access to equipment and medications: Medical supplies (like hospital beds, oxygen, or walkers) and medications related to the terminal illness are typically delivered directly to the home.
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24/7 support: Hospice providers offer round-the-clock phone access to nurses and can send someone out for urgent issues—even in the middle of the night.
Hospice care is designed to ease the burdens of the final stage of life—physically, emotionally, and logistically. Knowing what to expect can help families plan ahead and focus on what matters most: time, connection, and peace.
What to consider before starting hospice care
Choosing to begin hospice care is a deeply personal and often emotional decision. Before starting hospice, it’s helpful to explore a few key questions to ensure the care aligns with your or your loved one’s wishes and circumstances. Here are some important considerations to keep in mind.
1. What is the goal of care?
Before starting hospice, it’s important to ask: Are we still pursuing curative treatment, or is comfort the priority now?
Hospice care is designed for those who have decided to stop treatments aimed at curing their illness and instead focus on quality of life in their final months. If the goal is to ease pain, support emotional well-being, and remain at home or in a familiar setting, hospice might be the right fit.
2. Is the timing right for hospice?
Many families wait too long to consider hospice. It’s available to those with a prognosis of six months or less if the illness runs its natural course, but starting hospice earlier can provide more time for comfort care, relationship closure, and support. If there's increasing hospital use, rapid decline, or unmanaged symptoms, it may be time to consider hospice sooner rather than later.
3. What services does hospice provide?
Hospice care includes a team-based approach: nurses, doctors, aides, social workers, chaplains, and trained volunteers. Services typically include:
- Pain and symptom management
- Emotional and spiritual support
- Medical equipment and supplies (e.g., hospital beds, oxygen)
- Medications related to the terminal illness
- Respite care for family caregivers
- Bereavement support after death
Understanding what's included can help ease uncertainty and prevent gaps in care.
4. What is usually not included in hospice care?
While hospice covers a wide range of services, it’s not all-inclusive. Here are some things that are typically not covered:
- Curative treatments (like chemotherapy or dialysis)
- Emergency room visits or hospital stays unrelated to comfort care
- Medications not related to the terminal diagnosis
- Private-duty nursing (24/7 care)
- Room and board (if receiving care in a facility)
It’s important to clarify these limitations up front to avoid unexpected expenses or misunderstandings.
5. How much does hospice care cost?
Considering the cost is an incredibly important piece of any medical undertaking, especially given the high prices in the US. Luckily, in many cases, hospice care is fully covered:
- Medicare covers nearly all hospice-related costs under Medicare Part A, including care, supplies, equipment, and medications for the terminal diagnosis.
- Medicaid also covers hospice in most states.
- Private insurance typically follows Medicare guidelines.
- Some non-profit hospices offer sliding scale fees or charity care if someone is uninsured.
Certain costs may still arise—like room and board in a facility or medications unrelated to the hospice diagnosis—so it’s worth reviewing coverage and asking the hospice provider for a cost breakdown. Be sure to check out the sign up process for Medicare.
6. Where will care take place?
Hospice care can happen in many settings: your own home, an assisted living community, a nursing facility, or a dedicated hospice residence. Consider:
- Where the person wants to be
- Where support systems are strongest
- What resources (like family caregivers) are available in each setting
For many, being at home surrounded by familiar people and things is most comforting, but it’s important to be realistic about what care is possible in each setting.
7. Are you emotionally and logistically ready?
Hospice is as much about emotional support as it is medical care. Families should consider:
- Are we ready to accept the shift from curative to comfort-focused care?
- Do we have support for caregiving responsibilities?
- Have we discussed the person’s wishes and values about end-of-life care?
Hospice teams can help guide these conversations, but preparing emotionally and practically can make the process more peaceful.
Deciding to begin hospice care can feel overwhelming, but it’s also an opportunity to bring comfort, support, and dignity to the final stage of life. By understanding what hospice offers and thinking through these key considerations, you can make choices that reflect your values and needs—or those of someone you love.
If you’re thinking about starting hospice care for yourself or a loved one, Ever Loved’s key information checklist can help you stay organized during an emotional and overwhelming time. It offers a simple way to record important medical, legal, and personal details, share them with trusted family members, and ensure everyone is on the same page when decisions need to be made – all for free.
