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Hospice and palliative care

Get comfort, symptom support, and clearer decisions during serious illness.

Reviewed August 22, 2026

Palliative care focuses on relief from symptoms and stress at any stage of serious illness and can accompany treatment. Hospice is an interdisciplinary benefit for people expected to have about six months or less if illness follows its usual course, who choose comfort-focused care for the terminal illness. Hospice can continue beyond six months when eligibility is recertified.

Your next 3 actions

  1. Ask for a goals-of-care conversation now. Say what matters most: comfort, alertness, time at home, avoiding hospitalization, or attending an event.
  2. Request a palliative-care or hospice evaluation. An evaluation does not force enrollment. Compare at least two hospices if time allows.
  3. Write the after-hours plan on one page. Include the hospice or clinical number, comfort medications, who can consent, and when the family would call 911.

Options and tradeoffs

  • Palliative care: Available alongside disease-directed treatment. Access and insurance coverage vary by clinic and plan.
  • Hospice at home: The hospice team visits and supports the family, but does not usually place a caregiver in the home around the clock. Family or paid caregivers often provide day-to-day care.
  • Inpatient hospice or general inpatient care: Short-term care may be available for symptoms that cannot be managed elsewhere; it is not automatically a permanent residence.
  • Continue usual treatment: A person can decline hospice or revoke it later. Ask what treatments remain compatible with the hospice plan and diagnosis.

Questions to ask

  • What support is available nights, weekends, and during a symptom crisis?
  • How quickly can a nurse come? Who supplies medications and equipment?
  • Which treatments, medicines, ambulance trips, or hospital visits are related to the terminal illness and covered?
  • Where can care occur? What happens if home care becomes impossible?
  • How are pain, breathlessness, agitation, nausea, and caregiver exhaustion handled?
  • What respite and grief support are available?
  • Who will be the attending clinician? How can care be revoked or transferred?
  • How will cultural, spiritual, language, and family needs be respected?

Warning signs

Call the hospice first for an expected symptom crisis unless the agreed plan says otherwise. Call 911 for immediate danger when emergency treatment matches the person’s wishes. Do not wait for the next routine visit when pain, breathing, bleeding, agitation, or caregiver safety cannot be managed. Pause if a provider promises continuous bedside staffing without defining when it is available, or pressures a person to enroll without explaining choices.

Common failures

  • Waiting for the last days. Earlier referral can allow more symptom control, equipment, teaching, and family support.
  • Assuming hospice means “no care.” It changes the goal and team; it does not mean abandonment.
  • Assuming all treatment stops. Ask what is related to comfort, what remains covered, and what choices the patient retains.
  • No caregiver plan. Hospice visits do not replace all hands-on care at home.
  • Unclear emergency wishes. Record the plan and make advance-directive and portable medical-order documents easy to find.

Costs and payment basics

Medicare Part A covers hospice for eligible beneficiaries through a Medicare-approved hospice after certification and election of the benefit. There can be small cost sharing for outpatient drugs for symptom control and respite care. Room and board are generally not covered when hospice is provided in a residence or long-term care facility. Medicaid, VA benefits, employer insurance, and private plans have their own rules. Palliative-care visits are usually billed like other specialty care.

King County help

Sources

Reviewed 2026-08-23.