Hospice is a type of medical care focused on comfort and quality of life for individuals with a serious illness who are no longer seeking curative treatment. It aims to relieve pain, manage symptoms, and provide emotional, social and spiritual support to patients and their families as they approach the end of life.

Deciding to seek hospice care can be one of life’s most challenging decisions for caretakers and loved ones. Many patients and families express wishing they had understood more about hospice services and had chosen them sooner. This guide aims to clarify hospice services and outline signs that it may be time to consider them.

When to consider hospice services. A common misunderstanding is that hospice care is only for the last few days of life. Patients and families often benefit most when they have hospice care for the final months of life.

There are two parts to determining qualifications for hospice care: a terminal diagnosis and clinical decline. When treatment is no longer effective in the face of disease progression, such as with advanced stage cancer or end-stage lung, heart, kidney or liver disease, hospice services may be warranted. Signs of clinical decline may include any combination of the following:

Doctors have indicated that life expectancy is less than six months.
Frequent ER visits or hospitalizations in the last six months.
Unintentional weight loss.
Increased anxiety.
Increased pain medications.
Frequent falls or near falls.
Spends the majority of time in bed or a recliner.
Increased weakness and fatigue.
Increased shortness of breath.
Patient needs increased assistance with activities of daily living (ADLs) such as bathing, dressing, ambulation, transfers, toileting or eating.

Services provided by hospice care. Hospice services focus on providing comfort care, quality of life and dignity at the end of life. Hospice teams are trained to manage pain and other distressing symptoms such as nausea, poor sleep, anxiety, constipation, depression and shortness of breath, treating with medical therapies and medications when warranted.

Hospice provides durable medical equipment (DME), including hospital beds, walkers, oxygen concentrators, nebulizers and bedside commodes. Other supplies covered include incontinent supplies (such as Depends, briefs, and wipes) and all wound care supplies.

Additional services offered include:

Bereavement, spiritual and counseling support.
Volunteer support for light chores and companionship.
Availability of respite care to give caregivers short-term breaks, reducing burnout and providing relief.
Regular nursing visits to assess, support, educate and manage symptoms.

Since every individual is unique, hospice standardly provides individualized care for each patient, with nurses on call 24/7 and regular certified home health aide visits to assist with ADLs.

Practitioners who provide hospice services:

Medical physicians: Collaborate with a patient’s team and family to establish a plan of care and provide overall guidance for medical management of terminal illness.
Nurses: Provide head-to-toe assessment, education, coordination of care, wound treatment, symptom management and emotional support.
Certified home health aides: Provide assistance with ADLs, offer comfort and support and preserve dignity.
Social workers: Assist in locating resources, navigating the medical system and providing counseling support to cope with the emotional and spiritual aspects of illness and the dying process.
Faith counselors: Are available to offer spiritual support, last rites and ongoing support to families for up to 13 months following a patient’s death. These guides can help families and patients find meaning and peace during this transitional time.

Where hospice care can be implemented. Hospice services are rendered wherever a patient calls home: private residences, nursing homes, assisted living facilities and board and care facilities. If a family is no longer able to care for a patient at home, hospice can also assist in locating the right facility for the patient depending on finances and level of care.

How hospice is paid for. Most major insurances cover hospice care with no co-pay or out-of-pocket costs. It is important to ask your social worker or insurance carrier about coverage. Medicare, HMOs (such as Desert Oasis Healthcare or Kaiser), and private insurances customarily cover 100% of hospice care.

What is not covered under hospice. Hospice does not cover independent caregivers or room and board for the patient. Some secondary insurances may cover room and board at skilled nursing facilities under custodial care, so it is good to have a thorough understanding of your individualized plan.

How to choose a hospice care organization. The Centers for Medicare and Medicaid Services (cms.gov) have a hospice compare website to help guide, educate and inform. Read reviews on local organizations and interview up to three groups before making a decision. Be sure to meet the individual hospice care practitioners who will be caring for you or your loved one.

Choosing hospice care is never an easy decision, but it can be one of the most meaningful and supportive choices for individuals and families navigating the final chapter of life. Understanding when to consider hospice, what services are offered, and how care is provided can bring clarity and peace of mind during an otherwise uncertain time. Hospice is not about giving up—it’s about embracing comfort, dignity and the presence of a compassionate team dedicated to walking this journey alongside you.

If you or a loved one are facing a serious illness, having open conversations about hospice care can ensure that the final months, weeks or days are filled with the care, respect and support everyone deserves.

Patrick Chirwa is owner of Tranquility Sands Hospice in Palm Desert and welcomes your questions. He can be reached at (760) 565.1774 or Patrickc@tranquilitysandshospice.com.

Sources: 1) https://hospicefoundation.org/what-is-hospice/; 2) https://www.cms.gov/newsroom/fact-sheets/hospice-compare-website; 3) https://www.cms.gov/medicare/payment/fee-for-service-providers/hospice/hospice-regulations-and-notices