Questions people ask
Can you be on hospice and still have dialysis?
Sometimes. It depends on whether kidney failure is the illness that qualifies the person for hospice. When it is, dialysis is treatment aimed at the terminal illness and stops when hospice begins. When the terminal illness is something else, such as cancer or heart failure, dialysis treats a separate condition and can often continue under regular Medicare, arranged with the hospice. The hospice doctor and the kidney doctor decide it with the person, case by case.
Medically reviewed by Oscar Chien, MD, Medical Director, October 19, 2026
On this page (6 sections)
When does dialysis stop when hospice starts?
When kidney failure is the terminal diagnosis. Hospice is comfort care for the illness that is ending the person's life, and the hospice is responsible for all care related to that illness (42 CFR 418.24). Dialysis for that illness is treatment meant to prolong life, so electing hospice means stopping it. Many people choose hospice at exactly this point: when dialysis has become harder to bear than the illness. The hospice can start on the day of the last treatment.
When can dialysis continue on hospice?
When the terminal illness is something else and the kidney failure is a separate condition. Then dialysis is unrelated to the terminal illness and regular Medicare keeps paying for it, through the Medicare ESRD benefit, while hospice covers the care for the terminal illness. The hospice must agree that the kidney failure is unrelated, and it writes that down. The hospice and the dialysis center coordinate transport, timing and what happens if the person becomes too weak for treatments.
Ask before you elect hospice, not after. The hospice doctor, the nephrologist and the person decide together, and the hospice tells you in writing which services it considers unrelated if you ask for the election addendum.
What happens after dialysis stops?
Without dialysis, people with little or no kidney function usually live days to a few weeks, longer when some function remains. The hospice team manages the symptoms that come: tiredness, fluid build-up, itching, nausea, confusion, and at the end, sleepiness. Most people describe the last days as peaceful. Read hospice and kidney failure.
How to ask
- Ask the kidney doctor: is kidney failure the illness that would qualify me for hospice, or is it another illness?
- Ask the hospice: if I elect hospice for another illness, will you treat my kidney failure as unrelated, and will you put that in writing?
- Ask yourself and your family: is dialysis still giving me the life I want, or has it become the hardest part?
- Ask about conservative management: care for kidney failure without dialysis, which can go on for months before hospice is needed.
Related questions
Can you go on hospice without ever starting dialysis?
Yes. Kidney doctors call this conservative management. A person can be on hospice when a doctor certifies eligibility, and some people live many months this way, depending on how much kidney function remains.
If I stop dialysis for hospice and change my mind, can I restart?
Yes. You can leave hospice at any time and restart dialysis under regular Medicare. Read can you leave hospice.
Does the hospice pay for dialysis?
No. When dialysis continues on hospice it is because it is unrelated to the terminal illness, and regular Medicare pays for it as before.
Who decides whether kidney failure is related?
The hospice physician, on the medical facts, in consultation with the attending physician. The decision is documented and can be revisited if the facts change.
Read more
Hospice and kidney failure, the kidney disease criteria for clinicians and what hospice does and does not provide.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- October 19, 2026
- Next review
- April 19, 2027
How we write and review this site
Sources
- 42 CFR 418.24: Election of hospice care (opens in a new tab)
- CMS Medicare Benefit Policy Manual, chapter 11: End stage renal disease (opens in a new tab)
- Medicare.gov: Hospice care coverage (opens in a new tab)
- National Institute on Aging: Providing care and comfort at the end of life (opens in a new tab)
These sources support the general information on this page. For one personās care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (877) 258-7129 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the personās own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice