HOSPICE CARE

Hospice Eligibility: When To Start And What To Expect

Summary: You want to do the right thing for your loved one. If you are wondering whether it is time for hospice, this guide explains how eligibility works, the signs to watch for, and what to do next. You will learn how the six month standard is used, how different conditions qualify, and how care begins at home with a team that focuses on comfort and quality of life.

What Hospice Means and How Eligibility Works

Hospice focuses on comfort, dignity, and quality of life when a serious illness is no longer responding to curative treatment or when the goals of care have shifted away from cure. To start hospice, a physician certifies that the person is likely to have a life expectancy of about six months if the disease follows its usual course. This is not a timer. It is a clinical estimate that guides a switch to supportive care.

Key points to know:

• You do not have to be bedridden to qualify. Eligibility is based on overall decline and the impact of the illness on daily life.
• You can keep your personal physician. Hospice adds an interdisciplinary team that includes nurses, aides, a social worker, a chaplain, and a physician who oversees comfort-focused care.
• You can revoke hospice if goals change. If treatments become appropriate again, you can leave hospice and later return if needed.
• If your loved one lives longer than six months, hospice can be recertified as long as eligibility criteria continue to be met.

The Signs that Suggest It May Be Time

You may notice patterns that point to a need for more support and a shift in goals. Look for clusters of changes rather than a single event.

Common signs families see:

• Frequent hospital or ER visits over the past few months for the same condition.
• Uncontrolled symptoms such as pain, breathlessness, nausea, anxiety, or agitation despite routine care.
• Weight loss or poor appetite, especially when meals are tiring or swallowing is harder.
• Decline in function, such as needing more help with bathing, dressing, walking, toileting, or eating.
• More time resting or sleeping, less interest in activities, or withdrawing from conversations.
• Multiple infections like pneumonia or urinary infections that are hard to recover from.
• Falls or increased safety concerns at home.
• Caregiver strain that makes daily routines feel unsafe or unsustainable.

If several of these are present, it is reasonable to ask the physician about a hospice evaluation.

Eligibility By Condition

Clinicians look at overall health, disease stage, and functional decline. Here is how that often translates for common illnesses.

Cancer

• Rapid weight loss, progressive weakness, or symptoms not controlled by standard treatments.
• The decision to stop curative chemotherapy or radiation, or when treatments are no longer effective or tolerated.

Heart disease (CHF and other advanced cardiac conditions)

• Shortness of breath at rest or with minimal activity, frequent hospitalizations for fluid overload, low blood pressure, or progressive decline in tolerance for activity.
• Dependence on high dose diuretics, oxygen, or repeated intravenous medications.

Lung disease (COPD, pulmonary fibrosis)

• Shortness of breath with basic tasks, oxygen requirement that is increasing, frequent exacerbations or pneumonias, unintentional weight loss, or high carbon dioxide levels.

Dementia and Alzheimer’s disease

• Dependence in most activities of daily living, difficulty with speech or comprehension, weight loss, swallowing problems, repeated infections, or very limited mobility.
• Families often notice longer sleep periods, quietness, and less interest in eating.

Neurologic conditions (Parkinson’s disease, ALS, stroke)

• Significant weakness, speech or swallowing challenges, frequent aspiration, recurrent infections, or increasing reliance on others for daily care.

Kidney and liver disease

• Decision to stop or not start dialysis, or progressive complications of liver disease such as ascites, confusion, or poor nutrition.

You do not need to memorize criteria. A hospice nurse can review the medical history and current changes, then coordinate with the physician to confirm eligibility.

Hospice vs palliative care

It helps to think of palliative care as symptom relief and support at any stage of serious illness, even while receiving curative treatments. Hospice is a type of palliative care that begins when the focus is fully on comfort rather than cure and when life expectancy is likely six months or less. If you are unsure which is right, a conversation with your physician or a hospice nurse can clarify the next best step.

What hospice provides at home

Once eligibility is confirmed, services are tailored to your needs and can begin quickly. The goal is fewer crises and more comfort where you live.

Typical support includes:

• Regular nurse visits to manage pain, breathlessness, nausea, anxiety, and other symptoms.
• Medications, equipment, and supplies related to the terminal illness, such as comfort medications, oxygen, a hospital bed, or wound care supplies.
• Certified nursing assistant visits for personal care like bathing and grooming.
• Social worker support for planning, resources, and caregiver guidance.
• Spiritual care that respects your beliefs and preferences.
• On-call support 24/7 for urgent concerns, so many issues can be handled at home.
• Respite and bereavement services to support caregivers now and after a loss.

You can keep seeing your primary doctor if you wish. Hospice coordinates with your doctor to keep the plan aligned with your goals.

How to start hospice in simple steps

1. Talk with the physician about the changes you are seeing. Share specific examples of symptoms, falls, infections, or hospital visits.
2. Request a hospice evaluation. A hospice clinician can visit, review medications and records, and explain services and coverage.
3. Choose your plan of care. You decide which services to accept. The team updates the plan as needs change.
4. Set up equipment and medications. Delivery is arranged to your home, and the nurse explains how and when to use each item.
5. Meet your team. You will know who to call for what, day or night.

What Happens If your Loved One Lives Longer Than Six Months

Many people improve once symptoms are controlled and crises are prevented. If the illness still limits life expectancy and criteria remain met, hospice continues with new certification periods. If your loved one stabilizes or chooses to pursue treatments again, hospice can be revoked, and services can resume later if needed.

Common questions families ask

Can you get hospice while receiving treatments?
You can continue treatments that are meant to relieve symptoms, such as oxygen or certain procedures. Treatments aimed at cure are usually paused during hospice. If goals change, you can revoke hospice and restart later.

Can you keep your current medications?
The hospice team reviews medications and focuses on those that support comfort and safety. Some long-term preventive drugs may be reduced or stopped if they no longer help with current goals.

Is hospice only for the last days of life?
No. Earlier support often improves comfort and reduces emergency visits. Many families say they wish they had started sooner.

Does hospice provide a caregiver in the home all day?
Hospice visits are scheduled and supported by a 24/7 on-call team. If you need extended hands-on help, the social worker can guide you to additional resources.

For more detailed answers, see our FAQ.

How to Talk with your Loved One About Hospice

Use honest, gentle language. Focus on goals such as staying comfortable, remaining at home, and avoiding stressful hospital trips. Ask what matters most now. Share that hospice is an added layer of support and that you can change course if goals shift.

Safety Planning and Support for Caregivers

Caring at home feels easier with a simple plan:

• Keep a list of the top three symptoms to watch and what to do for each.
• Place emergency medications in one container with clear instructions.
• Review fall risks and remove clutter, loose rugs, or dim lighting.
• Keep the hospice number visible by the phone for after-hours support.

Your team will adjust visit frequency if needs increase. If symptoms become very difficult, short-term inpatient care may be arranged.

When to Call for a Hospice Evaluation Right Away

• New or worsening shortness of breath
• Uncontrolled pain or anxiety
• Repeated infections or rapid decline over weeks
• Difficulty swallowing with coughing or choking on liquids
• Several falls in a short time
• Caregiver exhaustion that makes care unsafe

If any of these are happening, reach out today. A conversation costs nothing and may bring clarity and relief.

Hospice Eligibility Support: Speak With Our Care Team Today

If you think it may be time for hospice, we will listen, answer questions, and help you decide. Call (404) 921-3341 to speak with our care team now. You can also reach us through Services or Contact. If hospice is not the right fit yet, we will guide you toward palliative care and resources that meet your needs.