Transitioning to hospice care: When and how to make the choice

Few discussions and decisions are as difficult as those concerning hospice care. The conversations will be extensive and emotionally challenging, whether the patient in question is yourself or a loved one. It’s important to have the facts in hand and proceed in a measured, step-by-step manner to consider all the medical, logistical and personal aspects required to make fully informed decisions.

After gathering information and getting answers to some key hospice-related questions, you can use our step-by-step checklists to help you make the best possible choice for you or your loved one. Please remember that a decision on whether to transition to hospice will require additional thought and consultation with trusted health care professionals, but this can provide a good starting point.

Key questions about transitioning to hospice care

Below are answers to some of the most common questions of Enhabit Home Health & Hospice’s hospice clinicians.

Is hospice care the same as palliative care?

While both provide comfort care, symptom relief and pain management, palliative care can be provided regardless of prognosis or life expectancy and can be given together with curative treatment. Hospice care is limited to patients with a terminal illness who have decided to stop curative treatments.

Who is eligible for hospice?

Hospice care is available to patients with a life expectancy of six months or less as determined by their physician(s) and the hospice medical director.

Who starts the conversation about hospice? The patient or the physician?

Often, a primary care physician (PCP) or hospital-based physician will recommend hospice care. However, if the patient or a family member is considering the option, they should alert the physician sooner rather than later. Many of our patients and their loved ones report that they wish they’d begun researching and discussing hospice sooner.

Who makes the decision about accepting hospice care?

The decision is made by the patient, usually after consultation with physicians and loved ones.

What happens if the patient changes their mind?

Patients can leave hospice at any time if they are dissatisfied, their condition improves, or they decide to restart curative treatment.

Can the patient continue to see their PCP?

Yes. Medicare allows the referring physician to remain the primary physician so long as that’s what the physician and patient prefer.

Are all patients eligible for home-based hospice?

Patients in need of acute medical care, 24/7 monitoring, or intensive pain management may be better served in an inpatient setting. In the absence of these needs, home-based hospice is often the best choice.

Questions for patients and their loved ones to consider when transitioning to hospice

Deciding on hospice for oneself or a loved one involves many considerations, questions and people — such as physicians, family members and loved ones. It is not a spur-of-the-moment decision and can take some time. There are no shortcuts.

Click here for a checklist of primary questions to consider when evaluating an individual for hospice. Then, use this checklist to evaluate a hospice provider. These checklists are not meant to be complete and binding but merely a good starting point.

Additional resources on hospice care

For additional information and answers about hospice care, please visit:

• Frequently Asked Questions About Hospice Care | National Institute on Aging (nih.gov)
• What Is Hospice Care? | American Cancer Society
• Hospice Care | Medicare.gov
• Hospice Care and Resources | Hospice Foundation of America

At Enhabit, we believe hospice is a philosophy of care that places importance on the comfort of every patient living with a terminal illness. Our coordinated team of caring professionals is dedicated to providing physical, spiritual and emotional support to patients and their loved ones.