When Is Hospice Care Recommended?

Published: March 5, 2024

Caring for a loved one with a serious illness often comes with many unknowns, and one of the most difficult questions caregivers face is, “Is it time for hospice care?” At Ascend Health, we walk alongside families and caregivers through every stage of this journey. If you’re wondering when to consider hospice, how it differs from palliative care, or what happens after a transition, this guide offers clarity, compassion, and support.

What Is Hospice Care?

Hospice care is a specialized form of support designed for individuals with a life-limiting illness. Rather than focusing on curing the illness, hospice prioritizes comfort, dignity, and quality of life, helping patients and families make the most of the time they have together. Hospice care includes:

Expert pain and symptom management
Emotional and spiritual support
Family and caregiver education
In-home nursing and caregiver services
Bereavement support for loved ones

Hospice is typically recommended when a physician believes a patient has a prognosis of six months or less, but what matters most is the focus of care, not the timeline.

When Is Hospice Care Appropriate?

Hospice care becomes appropriate when curative treatments are no longer effective or desired, and the goal of care shifts to comfort. This may occur gradually or follow a significant change in health.

Signs it Might be Time to Consider Hospice Care

Recognizing the signs that it may be time for hospice can be overwhelming, but awareness can help you and your loved one receive more supportive, meaningful care. Here are some signs that indicate it is time to consider hospice care:

Prognosis of six months or less: If your loved one’s doctor estimates a limited life expectancy, hospice may be appropriate.
Ineffective treatments: Your loved one’s condition continues to decline despite treatments, and more interventions are unlikely to help.
Growing dependence: Your loved one needs increasing help with basic daily activities like sitting up, toileting, or eating.
General decline: They are losing weight, growing persistently tired, and showing signs that the body is weakening.
Repeated infections: Frequent infections may signal a decline in immune function and overall health.
A desire for peace: Your loved one may say they’re “ready,” or express that they’ve had enough of treatments and just want to feel better.
Change in care goals: The focus has shifted to comfort, not cure, and to having more good days than bad.

These signs don’t mean giving up. They mean giving your loved one the care that best meets their current needs and values.

What Does “Transitioning” Mean in Hospice?

“Transitioning” in hospice refers to the shift in care goals — moving from treatment aimed at curing illness to care focused on comfort and support. This transition recognizes that the illness is no longer responding to treatment, emphasizes symptom relief, emotional well-being, and spiritual care, and brings in a coordinated team of hospice nurses, social workers, chaplains, and aides. At Ascend Health, we guide families through the transition process gently, ensuring patients and caregivers feel informed, supported, and never alone.

Can a Patient Switch from Palliative Care to Hospice Care?

Yes. Many patients begin their care journey with palliative care, support that helps manage pain and symptoms at any stage of illness, and later transition to hospice when the focus becomes entirely comfort-centered. As we mentioned before, you might consider switching from palliative care to hospice if:

Curative treatments are no longer working or are being stopped
The patient has a prognosis of six months or less
The priority becomes symptom management and quality of life at home

As a provider of both hospice and palliative care, Ascend Health can help assess your loved one’s condition and guide you through the transition, with no pressure, just support and understanding.

Who Can Refer a Patient to Hospice?

Many people assume they must wait for a doctor to bring up hospice, but that’s not the case. Anyone can start the conversation, including family members, social workers, nurses, or even the patient themselves. Early involvement with hospice can lead to better symptom control, fewer hospital visits, more time at home with loved ones, and meaningful emotional support for both patients and caregivers.

What Is the Difference Between Palliative Care and Hospice?

While both palliative and hospice care provide comfort and relief from suffering, they differ in timing, intent, and eligibility.

Palliative Care vs Hospice

	Palliative Care	Hospice Care
Timing	Any stage of serious illness	Final stage (prognosis of 6 months or less)
Goal	Improve quality of life during treatment	Provide comfort at end of life
Treatment Type	Can be provided alongside curative treatment	Curative treatments are no longer provided
Setting	Hospital, clinic, or home	Typically provided at home or a facility
Coverage	Often covered by insurance	Covered by Medicare, Medicaid, most insurers

What Happens When Transitioning from Palliative Care to Hospice Care?

Transitioning hospice care is a natural next step when comfort becomes the priority. Here’s what families can expect when transitioning from palliative to hospice:

1. Talk About Goals of Care

The care team, patient, and family discuss current needs and whether the focus is shifting from treatment to comfort. A doctor confirms if hospice is appropriate (usually with a prognosis of six months or less).

2. Coordinate Between Teams

If the patient is already receiving palliative care, the team works closely with hospice staff to ensure a smooth transition.

3. Enroll in Hospice Care

Hospice enrollment begins with consent forms, a referral, and a home visit to create a personalized care plan.

4. Receive Support at Home

Medical equipment, medications, and a dedicated care team (nurses, aides, social workers, chaplains) are provided at home.

5. Ongoing Family Support

Families receive education, 24/7 access to the hospice team, emotional and spiritual support, and respite care when needed.

At Ascend Health, we make this transition as smooth and supportive as possible, always centered on compassion, comfort, and dignity.

Why Hasn’t Our Doctor Mentioned Hospice Yet?

It’s a question many families ask: “If hospice is the right next step, why hasn’t our doctor brought it up?” There are several reasons, and many of them are human.

Optimism bias: Research shows that 63% of doctors overestimate survival, often due to fondness or recent contact with their patient.
Uncertainty in prognosis: It’s hard to predict life expectancy with precision, especially with multiple illnesses in play.
Perceived resistance: Sometimes, doctors sense that families aren’t ready for the conversation and try to respect that space.

We encourage families to speak up. Let your physician know when your hope shifts — when the goal becomes fewer treatments and more good days. We’re here to support both you and your medical team.