Is it time for hospice?

What are the general signs that hospice may be needed?

These signs apply across most serious illnesses. Doctors look at the overall direction over the past three to six months, not at one bad week.

• Two or more hospital stays or emergency room visits in the past six months for the same illness
• Weight loss without trying, less appetite, or trouble swallowing
• Sleeping much more of the day, or spending most of the day in a bed or chair
• Needing more help with bathing, dressing, eating, walking or using the toilet
• More frequent infections, such as pneumonia or urinary infections
• Falls, or growing weakness that does not improve after rest or rehabilitation
• Pain, shortness of breath or other symptoms that are harder to control
• Treatments that are no longer working, or side effects that outweigh the benefit
• The person says they are tired of going to the hospital, or wants to focus on comfort and being at home

What are the signs for specific illnesses?

Each illness has its own pattern. These are short summaries of what doctors often look for. Each links to a fuller page.

At what point do doctors recommend hospice?

Doctors usually raise hospice when they believe the illness is in its last months and further treatment is unlikely to help the person live longer or feel better. Many doctors ask themselves a simple question: would I be surprised if this person died in the next six months? If the answer is no, hospice is worth discussing.

Doctors do not always bring it up first. Some wait for the family to ask, and some are focused on the next treatment. You are allowed to ask the question yourself. Asking does not commit you to anything.

How do I raise hospice with the doctor?

A short, direct conversation is usually enough. These steps help you get a clear answer.

1. Step 1

   Write down what has changed

   List hospital stays, weight loss, falls, new symptoms and how much help the person needs now compared with three to six months ago. Bring the list to the visit or have it ready for a phone call.

2. Step 2

   Ask plain questions

   Try: What do you expect over the next six months? Are the treatments still helping? Would hospice or palliative care be appropriate now? What would you want for your own family member?

3. Step 3

   Say what matters to the person

   Tell the doctor what the person wants most, such as staying home, less pain, fewer hospital trips or more time awake with family. Goals shape the recommendation.

4. Step 4

   Ask for a hospice evaluation

   If the doctor agrees it is worth exploring, ask for a hospice evaluation. The doctor's office can send the request, or you can contact us and we will reach out to the doctor for you.

5. Step 5

   If it is not time yet, ask about palliative care

   Palliative care adds support for symptoms and stress while treatment continues. See hospice vs palliative care.

What does calling us involve?

A call is a conversation, not a commitment. Anyone can call: the person who is ill, a family member, a friend or a caregiver. You do not need a doctor's order to ask questions. A hospice nurse answers the phone 24 hours a day, 7 days a week, and can visit when needed.

We ask what is happening, what worries you most and who the person's doctor is. If it makes sense, we offer an informational visit at home, in the hospital or in a care facility. With permission, we contact the doctor and review medical records. Nothing starts unless a doctor certifies eligibility and the person, or their legal representative, chooses hospice in writing.

What happens when you call

1. Step 1

   Tell us what is happening

   Share the general situation and where the person is. You do not need every detail before calling.

2. Step 2

   Understand the options

   A member of the hospice team explains what care would look like for this person and arranges the clinical and coverage review.

3. Step 3

   Plan together

   If the person chooses hospice and the requirements are met, the person, the family and the hospice team write the plan of care together.

Is it too soon to call?

Families often tell hospice teams they wish they had called sooner. Hospice is designed to help for months, not only the last few days. Earlier care means more time to get symptoms under control, set up equipment, teach caregivers and avoid rushed trips to the emergency room.

If it turns out to be too early, nothing is lost. We will tell you so, explain what to watch for and suggest other support such as palliative care. Some people improve on hospice and are discharged, and they can return later if they become eligible again.

Choosing hospice is your decision. You can stop hospice at any time and return to regular Medicare coverage. You have the right to choose your hospice.

What about cost?

Worry about money should not delay the question. Medicare, Medi-Cal and most private plans include a hospice benefit. We check your benefits and tell you your costs before care starts. See paying for care.

Common questions