Why Do Most Patients Prefer Hospice Care at Home?

Most patients prefer hospice care at home because it allows them to receive clinical attention, therapeutic services and emotional support in the privacy and comfort of their residences. They can stay in familiar settings close to loved ones in the final stages of their lives.

A 2021 survey indicates that most seniors wish to age at home rather than move to a residential setting, such as an assisted living community. Various measures enable older adults to age in place safely and comfortably, including home care and home health care services, property adaptations and family caregiver training and support programs. Diverse community initiatives, such as home-delivered meals and senior companion programs, further support those living at home as they age.

For many seniors, preferences to stay at home extend to end-of-life care. Additionally, studies show that most older Americans prefer to die at home, with research indicating that around 70% of seniors desire a home death. Home hospice care bridges patients’ needs and wants, and the National Hospice and Palliative Care Organization reports that most hospice recipients remain at home.

According to physicians, the main reasons for choosing home death include being in a familiar setting with family, avoiding a clinical environment and retaining a degree of independence. That said, individuals’ circumstances affect their preferred care setting and place of death. For example, research suggests that those who experience hospital admission wish to go home, while those with chronic diseases prefer to move into a healthcare facility.   

Additionally, a 2017 report from KFF (figure 10) provides various senior preferences for death. Approximately 54% of all individuals want to avoid financial hardship for their families, 49% want to ensure professionals follow their care wishes and 48% want their families nearby. Other wishes include not burdening loved ones with difficult decisions, having spiritual peace and being pain-free.

At-home hospice services provide comfort, relief and practical support. Accounting for seniors’ preferences, the benefits of in-home hospice care include:

• Support in a familiar setting
• Stress relief for caregivers
• Affordability compared to a nursing home or stand-alone hospice facility (Although Medicare covers hospice services for eligible seniors, it doesn’t pay for room or board.)
• Flexibility regarding eating, sleeping, recreational times and visiting hours
• Support for families with education, training and grief counseling
• Skilled nursing and therapeutic services to manage pain, medication routines and symptoms
• Option for respite stays.  
• Pastoral care and counseling to enhance spiritual and emotional well-being