When a loved one is facing a serious illness, conversations about hospice can feel overwhelming. Many people associate hospice with giving up, but hospice care is designed to help patients focus on comfort, quality of life and support during the final stage of life.
According to palliative medicine physician Dr. Carrie Stallings, understanding what hospice is — and what it is not — can help families make informed decisions.
What is hospice care?
"Hospice is a philosophy of care and a service. It's not a specific place," Dr. Stallings said.
Hospice is intended for patients whose doctors believe they may have six months or less to live if their illness follows its expected course. It focuses on comfort and quality of life rather than treatments intended to cure disease or prolong life.
"If someone is in that fourth kind of goal of care where they feel like they have a limited time no matter what, and they would rather focus on quality over quantity, they would qualify for hospice," she said.
How is hospice different from palliative care?
Hospice is a type of palliative care, but the two terms are not interchangeable.
"The main thing is that palliative care includes hospice, but it also includes a lot more," Dr. Stallings said.
Unlike hospice, palliative care can be provided at any stage of a serious illness and alongside treatments intended to cure disease or prolong life. Hospice is specifically for patients who have chosen a comfort-focused approach to care near the end of life.
What support does hospice provide?
Most hospice care takes place wherever a patient calls home, including private residences, assisted living communities and long-term care facilities.
Hospice teams often include nurses, social workers, chaplains and home health aides. These professionals work together to manage symptoms, provide emotional support and help patients remain as comfortable as possible.
"The nurse that's visiting would be checking vital signs, making sure pain and symptoms are controlled," Dr. Stallings explained.
Hospice programs also provide 24/7 support, allowing patients and families to reach a nurse at any time if symptoms worsen or concerns arise.
Understanding the four levels of hospice care
Hospice care can be tailored to meet a patient's changing needs through four levels of care:
- Routine care is the most common level and includes regular visits from the hospice team — at home or in a long-term care facility.
- Continuous care provides short-term intensive support at home when symptoms become difficult to manage.
- General inpatient care is available when symptoms cannot be controlled at home and require short-term inpatient treatment in a hospice facility, hospital or nursing facility.
- Respite care provides short-term inpatient care for patients while family caregivers go out of town or take a temporary break (up to five days per quarter).
Is hospice the right choice?
"There's really no right or wrong decision," Dr. Stallings said. "It's really an individual personal decision based on what someone's goal is."
Patients who want to continue pursuing treatments intended to extend life may not be ready for hospice. For those considering hospice, Dr. Stallings encouraged open conversations with trusted health care providers.
"What I always recommend is talking with the doctor who knows you best," Dr. Stallings said. "Are their goals aligned with hospice? Because sometimes they are, sometimes they're not."
Understanding hospice care can help patients and families make informed decisions and access the support they need when it matters most.
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