How to Get Hospice Care at Home

Hospice care offers thoughtful, compassionate support for people nearing the end of life due to a terminal illness. 

This type of care focuses on dignity while easing discomfort and is available in different settings, including at home, where familiar surroundings can offer added peace and reassurance. Hospice support is typically reserved for those with a life expectancy of six months or less, as determined by a healthcare provider.

To best understand this service, consider a comparison of hospice care vs. palliative care. Hospice care is a type of palliative care that focuses on comfort and dignity during life's final chapter. While palliative care can begin at any stage of a serious illness, even while treatment is ongoing, hospice remains reserved for those nearing the end of life, when focus shifts from finding a cure to making each day as meaningful and comfortable as possible.

Hospice is intended for people with a life expectancy of six months or less. Sometimes, their condition improves enough that they no longer need hospice and can be discharged, which is often referred to as "graduating" from care.

For many, home is a place of comfort, where daily routines feel natural and loved ones are close by. This familiarity and comfort are why most people choose to receive hospice care at home, where they can remain in familiar surroundings and receive the medical, emotional, and spiritual support they need without leaving the place and people they love the most. 

If you're curious about how to get hospice care at home, here are the steps to help you through the process:

To qualify for hospice care at home, the patient must receive a formal diagnosis. A doctor or primary care physician must confirm a life expectancy of six months or less. This step helps ensure the right care, comfort, and support are available during this stage of life.

While your doctor or hospital can refer you to a local hospice provider, loved ones can also take the lead. Many families make a self-referral by contacting a hospice provider directly. This choice often follows thoughtful conversations with your healthcare team about care goals, treatment preferences, and the desire to receive support in the comfort of home.

Next, choose a hospice provider that fits your needs and values. You might consider recommendations from your doctor or turn to suggestions from family and friends who have had experience with hospice care in the past.

Hospice care can begin once a patient qualifies and they or their caregivers sign the necessary paperwork. If they're still in the hospital, the hospice team will help coordinate the move home. They'll also make sure to set up other aspects of care, like medical equipment and prescriptions, so the patient can begin receiving care at home.

Hospice care supports the whole person — beyond physical comfort, hospice services consider emotional, mental, and spiritual well-being. You can expect regular visits from a dedicated team that may include hospice doctors, nurses, social workers, and chaplains. Providers tailor care to each person's unique needs to foster peace, dignity, and the best possible quality of life in the time remaining.

While there are no strict rules for who can receive end-of-life care, there are certain factors that can help to determine if someone qualifies for palliative care at home:

• A Person With a Terminal Diagnosis: If a person has a life-limiting illness, and their healthcare provider believes they have six months or less to live, they can qualify for hospice care to receive the right comfort and support during this time.
• A Significant Drop in Body Weight: Losing about 10% of body weight while managing this condition, especially when combined with worsening health, can indicate that a person may be eligible for hospice care.
• Declining Cognitive and Functional Abilities: A person may qualify for hospice care when they experience cognitive decline, such as confusion or memory loss, and begin to lose the ability to perform daily tasks like eating, dressing, or communicating.
• Frequent Hospital Visits: Hospice care may also be appropriate for someone who has had multiple hospital stays, emergency visits, and physician appointments related to the progression of the illness.

Along with these factors, a physician must assess an individual's medical needs and home setting to ensure that the patient qualifies for home hospice. Patients who need complex care may be better served in a nursing home — the decision involves the patient and caregivers to find the best option.

Medicare, Medicaid, and most private insurance plans cover many parts of hospice care costs. However, there may be some out-of-pocket costs for services that aren't covered, such as certain prescriptions or respite care.

Your choice of hospice care primarily depends on the patient's needs, preferences, and insurance coverage. However, the right hospice care can be influenced by factors such as:

• Location and Accessibility: Choose a hospice provider that can easily reach your home to ensure timely and consistent care.
• Service Availability: Make sure the hospice offers the full range of services at home — like nursing visits, medication delivery, and equipment setup — to provide the best possible support during this stage.
• Religious Affiliation: When faith plays a central role for you or your loved one, it can be comforting to choose a hospice provider that offers spiritual care aligned with beliefs and values to strengthen a sense of connection and care in the final days.

Hospice care can be a final act of love, ensuring that you or your loved one spends their last days in comfort, dignity, and peace. While hospice services are available in settings like nursing homes, assisted living, or independent living communities, many people choose to receive this care at home, surrounded by familiar comforts and supported by a team of compassionate professionals.

Typically reserved for those with a life expectancy of six months or less, hospice care is often covered by Medicare, Medicaid, and most private insurance plans.

• Frequently asked questions about hospice care. (2021). National Institute on Aging
• Teoli, D., et al. (2023). Hospice appropriate diagnoses. StatPearls
• What are palliative care and hospice care? (2021). National Institute on Aging.