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What is Hospice?

Hospice care is a model of compassionate care given at the end of someone’s life. Also called end-of-life care, hospice care often involves a team of healthcare professionals to provide medical care, pain management, emotional support, and spiritual support. In hospice care, the focus is on caring, rather than curing, with the belief that each individual deserves to die pain-free and with dignity. Hospice care can also provide counseling support to the patient’s family members.1

Hospice for advanced breast cancer

In some cases of advanced breast cancer, when treatment is no longer controlling the disease, hospice care may be recommended for patients and their loved ones. Hospice care focuses on controlling pain and symptoms of breast cancer to allow patients to be as comfortable as possible near the end of life. The goal of hospice care isn’t to speed up or postpone death, and if the patient’s cancer goes into remission, hospice care can be discontinued or stopped. Making the choice to have hospice care doesn’t mean the patient is “giving up.” Rather, it means the priorities of treatment have changed.2

Hospice services and team

Hospice care may include medical professionals, medical equipment and supplies, short-term relief services for caregivers, medications to manage symptoms from advanced breast cancer, spiritual support, and counseling, and/or social work services. Hospice services are typically provided by a team of professionals, which may include doctors, nurses, home health aides, social workers, clergy or other spiritual counselors, physical or occupational therapists, and trained volunteers. Hospice care is often available to the patient and their family 7 days a week, with a team member on-call 24 hours a day. Hospice care is highly tailored to meet the needs and priorities of the patient and their family, to provide the care and support throughout the person’s life.2

Insurance coverage for hospice care

Most insurance plans, Medicare and Medicaid cover hospice care with a statement from a doctor explaining that the patient has a life expectancy of 6 months or less. The patient also must sign a statement to choose hospice care.2 While insurance plans require that a prognosis is 6 months or less, hospice care is not limited to six months. Care can continue as long as the patient needs it.3

Hospice improves quality of life

Researchers have studied the effects of hospice on end-of-life care. In one study, patients who entered into hospice care suffered less, were physically more capable, and were better able, for a longer period, to interact with others than those who didn’t use hospice care. In addition, after the patients who used hospice died, their family members were markedly less likely to experience persistent major depression, which seems to suggest the family support provided by hospice has a lasting benefit on family members.4,5

While many people assume that hospice care hastens death, because patients are choosing to discontinue cancer treatment like chemotherapy and are allowed higher doses of pain relievers, certain studies suggest the opposite is true. One study followed 4,493 Medicare patients who had either terminal cancer or end-stage congestive heart failure. For patients with breast cancer or prostate cancer, the researchers found no difference in survival time between the patients who went into hospice care versus those who didn’t. However, for some conditions, hospice care seemed to extend survival, such as patients with lung cancer, patients with pancreatic cancer, and patients with congestive heart failure.4,6

Hospice resources

There are two national organizations focused on hospice care2:

Both of these organizations provide information on hospice as well as locator services to find hospice in your area.

Written by: Emily Downward | Last reviewed: December 2018.
  1. Hospice care. National Hospice and Palliative Care Organization. Available at https://www.nhpco.org/about/hospice-care. Accessed 10/26/18.
  2. Choices for care when treatment may not be an option. National Cancer Institute. Available at https://www.cancer.gov/about-cancer/advanced-cancer/care-choices. Accessed 10/26/18.
  3. Key hospice messages. National Hospice and Palliative Care Organization. Available at https://www.nhpco.org/press-room/key-hospice-messages. Accessed 10/26/18.
  4. Gawande, Atul. Being Mortal: Medicine and What Matters in the End. New York: Metropolitan Books, Henry Holt and Company, 2014.
  5. Wright AA, Zhang B, Ray A, Mack JW, Trice E, et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008 Oct;300(14):1665-1673.
  6. Connor SR, Pyenson B, Fitch K, Spence C, Iwasaki K. Comparing hospice and nonhospice patient survival among patients who die within a three-year window. 2007 Mar;33(3):238-46.