Choosing hospice care program can be an extremely difficult decision for many patients and families. Whether looking to improve pain management, lessen caregiver burden or maximize quality of life, the decision to pursue hospice is never hard and fast.

1. Am I Ready for Hospice Care?
Dana Nolan, MS LMHC
Licensed Mental Health Counselor

2. What Is Hospice Care?
Patients with a limited prognosis
Usually home-based care
Caring vs. curing
Individual plan of care
Multidisciplinary
Family or caregiver support
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3. Criteria for Hospice Care
Patients may enter hospice care when their life expectancy is
6 months or less or if their illness runs its normal course.
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Patients with multiple serious illnesses
may meet criteria with physician
recommendation that the combination
of illnesses will shorten life expectancy.
Note: Use these as guides.

4. Statistics
 The first hospice organization was started in 1974.
 Today, there are close to 6,000 hospice programs
in the U.S.
 The average length of hospice service is about 72
days, but there is great variation in length of
service depending on timing of the referral and
patients acceptance of referral.
(800) 615-2270

5. Who Pays for Hospice Care?
 Hospice is covered under
Medicare, Medicaid (47 out of
50 states cover it) and most
private insurers.
 Patients receive hospice care
regardless of ability to pay
(sliding scale or
uncompensated/charity care).
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6. Who Should Talk About Hospice First?
Patients and families may bring up hospice care at
any time.
Patients and caregivers may be reluctant to ask
questions because they fear their oncologist will
think they have given up.
Physicians vary in how and when they may discuss
the potential of a hospice referral, but are usually
open to discussing it when their patients ask
questions about it.
(800) 615-2270

7. Who Provides Hospice Care?
 Multidisciplinary team: Physician, nurse,
counselor/social worker, chaplain, volunteers,
home health aids, ancillary (dietitian, OT/PT).
 Hospices usually employee physicians who
specialize in palliative care, but you can use your
PCP or oncologist if they are agreeable to continue
managing your care.
(800) 615-2270

8. Where Is Hospice Care Provided?
 Patient’s place of residence
which could be their home
or a nursing home (66%).
 Inpatient hospice facility
 Acute hospital setting
(800) 615-2270

9. Are All Hospices the Same?
 Certified hospices must all provide
the same basic level of care, but
many offer more services or have
their own inpatient facility so it is
worth interviewing several hospices.
 There may be more than one hospice
agency that provides care in your
area.
(800) 615-2270

10. Benefits of Hospice Care
 Home-based: bring care and equipment (shower
chair, hospital bed, supplies) to YOU.
 Individual care available (on call 24/7).
 Their specialty is end-of-life care (pain and symptom
management experts).
 Staff support and educate the caregivers on how to
best care for the patient.
(800) 615-2270

11. Can I Discontinue Hospice Care?
 Yes! If a new treatment becomes
available (or a clinical trial opens
up), you can discontinue hospice
care and resume curative
treatment.
 If you feel better or your disease
stabilizes, you can discontinue
hospice and resume if needed in
the future.
(800) 615-2270

12. How Will I Know It Is Time for Me to
Consider Hospice Care?
 Subjective quality of life
 Risk or benefit of further
curative treatment.
 Prognosis
 “What is important to me?”
(800) 615-2270

13. Family Issues
 Some patients decide they are ready for hospice
but don’t pursue it because family is not
supportive and wants patient to continue
treatment.
 “I can’t give up!” “I am not a quitter.” “Everyone
has told me to not give up hope and to keep
fighting.”
 The best support a mesothelioma patient can get
from their loved ones is hearing: “I’ll support
whatever treatment decision you choose.”
(800) 615-2270

14. Resources for Hospice Care Questions
Health care chaplains
Oncology social workers or
mental health professionals
Oncologist or oncology nurses
Hospice agencies
(800) 615-2270

15. Sources
National Hospice and Palliative Care Organization
(2014) NHPCO’s Facts and Figures: Hospice Care in
America.
Hospice Net (2016) Questions about Hospice. Retrieved
from http://www.hospicenet.org/html/faq-pr.html
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16. Contact Information
1-800-615-2270
(800) 615-2270