What is end-of-life care?

What does end-of-life care mean?

End-of-life care means the support and medical care given in the time around death. The National Institute on Aging describes four kinds of need it answers: physical comfort, mental and emotional needs, spiritual needs, and practical tasks. It includes the family, who need support as well.

The term covers care in any setting and under any payer. A doctor adjusting pain medicine in a hospital, a hospice nurse visiting at home, a chaplain sitting with a family, and a neighbor bringing meals are all part of it. When people search for "end-of-life care at home", what they usually need is hospice.

End-of-life care, hospice and palliative care

The three terms overlap. End-of-life care is the broad idea. Hospice and palliative care are the two ways it is organized and paid for.

The full comparison is on hospice vs palliative care.

Is end-of-life care the same as hospice?

Not quite. Hospice is one form of end-of-life care, and the most complete one. Under Medicare, a person can elect hospice when their doctor and the hospice doctor certify that life expectancy is six months or less if the illness runs its usual course (42 CFR 418.20). The hospice then brings a team to wherever the person lives, with the medicines, equipment and supplies related to the illness. Read hospice care.

A person can receive end-of-life care without hospice, for example in a hospital, or at home with the family and their own doctors. They give up the hospice team, the nurse who answers at any hour, and the bundled coverage for comfort medicines and equipment.

Is palliative care end-of-life care?

It can be, but palliative care is for anyone with a serious illness, at any stage, including people still having treatment. It does not need a six-month prognosis. Many people have palliative care first and move to hospice later, when treatment stops helping or they choose to stop it. Read palliative care.

Where does end-of-life care happen?

Wherever the person is: at home, in a family member's home, in an assisted living or board-and-care home, in a nursing facility or in a hospital. Hospice comes to any of these. In a hospital, hospice care is usually a short inpatient stay for symptoms that cannot be managed where the person lives.

Many people say they would like to die at home. It is possible with hospice and with family or hired help between visits. Read dying at home: what it takes.

Who pays for end-of-life care in California?

It depends on which kind of care. Hospice is covered by Medicare Part A, by Medi-Cal and by most private and employer health plans. Under Medicare, most people pay nothing for hospice care itself. There can be a copay of up to $5 per prescription for symptom medicines, and 5% of the Medicare amount for inpatient respite care. Medicare does not pay room and board where you live.

Palliative care is billed like other medical visits, so deductibles and copays can apply. Hired caregivers at home are paid privately, by long-term care insurance, or for people with Medi-Cal who qualify, through In-Home Supportive Services. Read paying for care.

End-of-life care in Los Angeles and Southern California

Beta Hospice Care gives hospice care at home, in assisted living and in nursing facilities across San Bernardino, Riverside, Los Angeles, Orange and Ventura counties. We care for adults only. A hospice nurse answers the phone 24 hours a day, 7 days a week, and can visit when needed. See our service area and Los Angeles County. To ask a question or request a hospice evaluation, call (877) 258-7129.

Common questions about end-of-life care