What is hospice?
Hospice is a special kind of health care for people who have a terminal illness. It is not "giving up," but rather a different type of care that focuses on quality of life and on pain and symptom control instead of on curative treatment.
What are the basic requirements to receive hospice care?
Choosing hospice care often requires a shift in the focus of care for people who know they have a life limiting illness. Basic requirements to participate in hospice include:
- You understand that you have a terminal illness.
- You accept a shift in health care from curative care to comfort care, which focuses on aggressive pain and symptom control.
- Two physicians agree that in their best clinical judgment, you are most likely in the final six months of your life.
- You are willing to have someone help make health care decisions for you if you are unable to make them for yourself.
Where does hospice care take place?
Most often hospice care happens in your home, with familiar and comfortable things around you. Your caregiver is supported by the hospice team, which includes nurses, home health aides, a social worker and chaplain all working together with your doctor to keep you as comfortable as possible.
You also are able to receive hospice care in a skilled nursing facility, assisted living facility or sometimes at a hospital if that is appropriate. Residential hospices may be available for those who choose not to live at home.
How much does hospice care cost?
Hospice care is covered by most insurance carriers including Medicare, Medicaid and private insurers. The hospice receives payment from your insurance carrier on a per diem basis, which means that all care is provided for a fixed daily rate that varies slightly by geographical location and from insurer to insurer.
If you do not have health insurance, you still will be eligible for hospice care, often at no or very little cost to you and your family. You should check with the hospice provider you select about any additional costs for care not covered by insurance.
What does hospice cover?
Hospice coverage provides comprehensive medical care related to your terminal illness. It includes most medications, medical supplies and durable medical equipment, such as a hospital bed in your home.
It also covers payment for visits to your home, or wherever you are receiving your care, by the hospice team. Members of the team may include:
- Your physician — who continues to oversee your care
- Hospice Medical Director — who works with your physician and other members of the hospice team to coordinate your care
- Registered nurse — who will visit you in your home to manage your clinical care
- Social worker — who will help you with concerns about personal issues and your family and friends
- Home health aide — who will help you with activities of daily living
- Chaplain — who will help you with spiritual concerns you may have
- Volunteers — who are specially trained to provide you with companionship or special needs
- Physical, speech, or occupational therapists, as needed — to improve your quality of life
- Bereavement counselors — to help those who love and care for you cope after your death
Can I still get hospice care if I live alone?
It is possible to get hospice care if you are used to living alone. Special considerations will have to be addressed, however. For example, how will people caring for you get into your home if you are unable to answer the door? Who will make decisions for you if you are no longer able to make them for yourself? To discuss the option of hospice if you live alone, you should talk to the hospice provider you select or to the social worker helping you with hospice arrangements.
The Living Alone program at Penn Medicine Hospice allows patients with no primary caregiver to receive hospice services for as long as possible and, when feasible, to die at home. To be considered, patients must meet certain admission criteria including adequate housing, mobility, and implementation of special home safety and emergency measures. Special services are provided to ensure the patient's safety and comfort.
How do I learn more about hospice?
Let your doctor, nurse or social worker know you are interested in hospice care for yourself or someone you love.
They can advise you on whom to contact and how to make arrangements for hospice.
For more information about hospice, you can us at
610-617-2400 or 800-700-8807 or by email at PMHospiceReferrals@pennmedicine.upenn.edu.