Since 1982, hospice care has offered patients in the U.S. end-of-life care with a focus on quality of life and dignity. If a doctor recommends you or a loved one enter hospice care, you might wonder how long it can last.

In this guide, we’ll answer important questions about hospice care duration and care qualification. Plus, we’ll share some helpful tips about knowing when the end of life is near.

Key Takeaways 

• Some patients can live up to 6 months in hospice care because that is the maximum time they are eligible for.
  
  

• To qualify, a person must be diagnosed with a life-limiting condition and a prognosis of under 6 months.
  
  

• End-of-life tips include communicating with loved ones, seeking emotional support, communicating with healthcare professionals, and ensuring all legalities are taken care of.

  
  

How Long Can a Person Be in Hospice Care?

When a loved one enters hospice care, it means the end of life is near. Hospice offers patients a dignified and pain-free death with care that seeks to improve their quality of life. However, this is not always the case. Going into hospice care does not necessarily mean the patient is living out their final days. 

The length of stay in hospice care is actually dependent on the patient’s diagnosis and their personal preferences. Some patients will stay in hospice anywhere from a week to 6 months. 

According to the Journal of Palliative Medicine, around 50% of patients enrolled in hospice die within three weeks. This is not uncommon, as many terminal patients will enroll in hospice care when they know the end is near. 

On the other hand, the study also found between 12% and 15% of patients stay in hospice for around 6 months. Diagnosis plays a big role in how long a patient will stay, for example, if they have a stroke or dementia. In 2014, the four most common illnesses were cancer, dementia, heart disease and lung disease. Around 36% percent of patients in hospice care were diagnosed with cancer, 14% with dementia and heart disease, and 9% with lung disease.   

Some patients can live up to 6 months in hospice care because that is the maximum time they are eligible for. However, there are some exceptions where hospice is extended. It’s not entirely uncommon for patients' conditions to improve in hospice care with an increased life expectancy, giving them another opportunity to start treatment again. 

How Can You Qualify for Hospice Care?

Since 1982, Medicare has offered hospice benefits. When someone wants to enroll in hospice care, they must meet the requirements listed by the U.S. Centers for Medicare and Medicaid Services. Other private medical insurance companies may also have very similar requirements to qualify. 

U.S. Centers for Medicare & Medicaid Services breaks down the qualification requirements into three categories: hospice eligibility requirements, disease-specific hospice eligibility criteria and financial requirements. It’s up to healthcare professionals like a doctor or specialist to certify someone qualifies for a referral to a hospice provider. 

Hospice eligibility requirements:

• A diagnosis of a life-limiting condition with a prognosis of under 6 months

• There has been progressive weight loss (more than 10% of body weight over 4 to 6 months)

• They require dependence in at least 3 of 6 activities of daily living (eating, dressing, bathing, walking and continence) 

• Changes in cognitive and functional abilities 

• Decreased mental abilities 

• Frequent hospitalizations (More than three between 4 to 6 months) 

• Increased weakness and fatigue 

• Increased infections 

• Decline in overall condition 

These guidelines will guide healthcare professionals in making their decisions. 

Disease-Specific Hospice Eligibility Criteria:

Some diseases will come with specific qualification guidelines. For example, patients with end-stage ALS are determined by their ability to breathe and swallow. Patients with dementia or Alzheimer's who cannot move around or carry out activities of daily living will also qualify for hospice care. 

Financial Requirements for Hospice:

Different medical insurances have their own financial requirements patients must meet to qualify for hospice care. For example, if someone has Medicare Part A, they will qualify for hospice care from a Medicare-certified hospice and sign a statement that waives all rights to Medicare payments for terminal illness or related conditions. They must follow up with their medical insurance provider to see what requirements they provide. If the doctor feels they don’t meet the requirements, they will unfortunately not qualify for hospice care. 

You can keep all your important medical documents and information secure in one place with Trustworthy, including emergency contacts and emergency planning. With our system, you can rest assured your documents are safe, plus, you can share them with family members.

Can You Live in Hospice Care for Over 6 Months?

It is possible to live in hospice care for over 6 months. However, the likelihood of this happening is not particularly high, as hospice care is for terminal patients and those who are living in their final days. 

For example, Medicare only allocates terminal patients two periods of 90-day benefits with an unlimited number of 60-day benefit periods. So, if they’re still in hospice after 6 months, their doctor will need to recertify them as terminally ill for a period of 60 days. For each 60-day period, the doctor will need to recertify their illness for as long as they stay in hospice care. In theory, this means people can remain in hospice longer than 6 months. 

Tips When You Know the End of Life Is Near

While it’s not possible to know when exactly a loved one will pass, there are symptoms you can look out for to give you an idea that the end of life is near. Knowing this, you can make your decision on when to enroll them in hospice care to prepare yourself and your loved ones. 

Dr. Pauline Moyaert, a Belgian nuclear medicine resident and dementia researcher says:

“The first sign you may notice is a decreased appetite… Digesting food requires a level of energy the dying person just may not have… A dying person’s body is also re-allocating limited energy supplies to keep the essentials running.”

She also explains:

“As the body dies, respiration progressively becomes a solely involuntary act controlled by the brain stem… Breathing often becomes irregular. There might be periods where the person is unable to breathe at all for as long as 10 to 20 seconds at a time… On top of this irregular breathing pattern, you may also notice a gurgling sound each time a patient breathes.”

Finally, she adds:

“You may find your loved one, who is typically lethargic, trying to stand up, get out of bed, or change position. They may tug at their clothes or bedding. They may not recognize you or yell at you using language you’ve never heard from them before.”

If you or a loved one are experiencing these symptoms, here are some tips for what can be done near the end of life. 

Ensure You Communicate with Loved Ones

As the end of life draws near, people want to communicate with their loved ones, like family and friends. Let your family know how you are feeling. Sometimes, this could also mean being open about fears. If you have any questions or want to say your goodbyes, this is the time to do it. Some patients prefer to reminisce about past times or ask more spiritual questions than they normally would.

Openly Communicate with Healthcare Professionals

At this stage of illness, communicate openly with your healthcare professionals and let them know your thoughts and worries. If you or your loved one are experiencing pain or new symptoms, let them know when it happens. They’ve dealt with these emotional and physical symptoms before and may be able to ease your mind. Openly communicating with your healthcare professionals can help them prepare your family for the end, which is near. 

Seek Emotional Support

Dying is scary, no matter how much we can prepare for it. It’s common to need emotional support during the end stages of life. Many people seek religious or spiritual support at this time. You can also lean on your family or loved ones for emotional support if they can provide it.

Tell Loved Ones Your Death Wishes

If the person in hospice has any death wishes, now is the time to share them with your loved ones. These wishes could include some things they want at their funeral, a special message for a loved one, or even a request they want to be carried out.

Keep all your emergency plans, like your funeral arrangements, on Trustworthy, where you can set access permissions for your loved ones should they need this information. 

Ensure Legalities & Finances Are Settled 

Be sure to settle all your finances and legalities. This includes your will, property and estate papers, and taxes, which are all sorted out. All your insurance policies and other sources of money should have a named beneficiary. 

Using a family operating system like Trustworthy can help you keep all your important documents organized and make it easy for your loved ones to access these secure documents. 

Frequently Asked Questions (FAQs)

How long is the average person in hospice?

The length of stay depends on diagnosis, but on average, the stay is around 70 days. 

What is the longest stay in hospice?

The maximum length of eligibility is 6 months. After that, a 60-day benefit period will need to be applied until the patient passes away. 

Does Medicare pay for end-of-life hospice care?

Yes, Medicare will pay if you meet the qualifying requirements like being diagnosed with a life-limiting condition with a prognosis of 6 months or less.