Does Hospice Mean Death?

Many people wonder whether choosing hospice care means that they are giving up hope, or if it means they are choosing death. In fact, this is not what hospice means at all.

Personal care assistant chatting with woman as she lies in bed
Gary John Norman / Getty Images

Here's what to know about the goals and benefits of hospice care. Understanding what hospice really means and clearing up any misconceptions you may have can help you decide if this is the right choice for you or your loved one.

The Purpose of Hospice

Patients and their families often choose hospice care when it has been determined that the person's disease is no longer curable, and thus is considered a terminal illness.

Instead of focusing on curative treatments (such as chemotherapy or surgeries), hospice focuses on treating the symptoms of an illness, such as pain, nausea, or shortness of breath. Hospice programs may also provide social workers and spiritual counselors to help the patient come to terms with their prognosis and, in some cases, mend relationships between the patient and their loved ones.

Most hospice care is covered by the Medicare Hospice Benefit (MHB). The MHB covers four levels of care, including:

  • Routine home care: This includes intermittent nursing services, medical supplies, and physical therapy, among other services that are provided in the patient's home.
  • General inpatient hospice care: This includes care for distressing symptoms that can only be provided in a hospital or other setting where intensive nursing and other support is available outside of the home. 
  • Respite care: Respite care is short-term inpatient care designed to relieve the primary caregiver temporarily.
  • Continuous home care: Continuous care supports the patient and their caregiver through brief periods of crisis, providing nursing, home health aide, and housekeeping services for 8-24 hours a day. 

Redefining Hope

People who choose hospice care are not giving up hope; they are in fact redefining it. Although there may no longer be a possibility of curing their illness, they redirect their hope into mending and restoring relationships, spending quality time with those they love, and finding peace and comfort.

Some people may turn to their religious faith at this time and settle financial affairs or other parts of their lives that they don't want to leave unresolved.

Most patients spend about three weeks in hospice, but, in retrospect, families may feel the person should have entered hospice earlier in the disease process and had more time to experience the benefits.

What Hospice Looks Like

Hospice is not a physical place, but an overall philosophy of caring for someone at the end of life. That said, there are free-standing facilities that provide hospice care when it is not possible for someone to live in their own home. Either way, hospice typically involves a team of nurses, social workers, health aides, and more.

At-Home Hospice Care

Most hospice care is provided where the patient lives, whether it is their private home, a nursing home, or an assisted living complex. Being surrounded by one's familiar belongings and surroundings is a core tenet of hospice care.

Hospice Facilities

Free-standing hospice facilities may be operated by a hospice agency that also offers in-home care, or be independently owned. For patients that don't have have caregivers to care for them at home, or those that need more advanced physical care 24/7, a free-standing hospice may be a good choice.

Choosing Hospice Doesn't Mean Choosing Death

Choosing hospice means choosing to focus on living as fully and comfortably as possible during the time you have left. People who qualify for hospice are usually expected to die in six months or less, but that doesn't mean dying is their focus. Many people live much longer than six months, in fact. You can stop and re-start hospice care anytime.

Usually, once someone has chosen hospice, they have been through a lot already. Multiple hospital admissions, chemotherapy and radiation, and invasive tests and treatments can leave patients feeling sick and tired. Hospice care can prevent people from living out the end of their lives in pain and exhaustion.

That said, hospice care isn't just for cancer patients. In fact, hospice patients often have medical conditions such as dementia, heart disease, liver disease, kidney disease, or lung disease.

By choosing hospice, patients focus on the quality of their lives rather than on how long they can keep living, especially if living longer means living with stress and without time to engage in the activities that really matter. With this view in mind, it's clear that choosing hospice is about choosing quality over quantity.

People often get confused about the difference between hospice care and palliative care. The goal of palliative care is to relieve pain. It can be provided anytime during the course of an illness, even in conjunction with curative treatments. Palliative care is one aspect of hospice care, but with hospice, curative treatments have been stopped and the patient's life expectancy is six months or less.

What Hospice Allows

Hospice patients who are still mobile and energetic may use the time that was once consumed by doctor's appointments and hospital stays to take family vacations, travel to places they've always wanted to see, and enjoy the company of loved ones.

If and when a patient is no longer able to leave home (or a hospice facility), the hope is that the patient will be able to spend meaningful time with the important people in their lives, and leave much of the hands-on caregiving to the hospice team, who can help with bathing the patient, giving them medications, preparing food, and even helping with paperwork.

In hospice care, patients have access to healthcare professionals with expertise in pain management and the care and medications that can alleviate discomfort. Dying patients also have access to emotional, social, and spiritual support from social workers and chaplains.

As a person nears the end of life, they may worry about what will happen after they die. They may also have “unfinished business” that they want to resolve. Social workers and spiritual counselors may help with this and also help them let go of any guilt or shame they may feel about things that happened during their lives.

A Word From Verywell

Ultimately, only you can decide when and where you'd like to spend to your last days. You may have accepted that further medical treatment will not cure your illness, and that you don't want to die in a hospital. By choosing hospice care, you will be able to remain in familiar surroundings with the important people in your life.

While choosing hospice care means that you've accepted that your illness is no longer curable, it does not have to mean giving up hope.

Was this page helpful?
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Cancer Society. How and where is hospice care provided and how is it paid for?

  2. World Health Organization. Palliative care. Updated August 5, 2020.

Additional Reading