What is Hospice

Hospice is a specialized, compassionate approach to caring for those with serious illness who may have weeks or months, rather than years, to live. The focus is on caring for the whole person, with expert pain and symptom management and emotional and spiritual support, to improve quality of life. When your illness is progressing despite aggressive treatments, and you and your family want to focus on comfort and quality of life, rather than curing your disease, and it may be time to talk about hospice.

Care is provided in your home, wherever you call home, by a dedicated and specially trained interdisciplinary team of professionals, who work closely with your physicians.

Hospice is 100% covered by Medicare for all eligible patients and is covered by most Medicaid and commercial insurance plans. Anyone can refer a patient to hospice, and the evaluation is free.

Eligibility Guidelines

Studies have shown those who choose hospice care
can actually live longer and better lives.

Levels of Hospice Care

Hospice offers four levels of care customized to meet the individial needs of the patient including physical, psychological and emotional needs. The four levels of care are listed below:

Routine Care

is provided in the comfort of your home, wherever you call home. This is the most common level of hospice care.

Inpatient Care

is provided when pain and symptoms become difficult to manage at home. Once symptoms are under control, the patient can return home.

Crisis Care

provides intensive care in the home setting for brief periods, when a patient requires skilled nursing care to manage difficult pain and symptoms.

Respite Care

provides temporary, short-term care for patients to relieve their family member who is the primary caregiver.

When to Consider Hospice Care

Hospice is a special way of caring for people with terminal illness. Knowing when to schedule a hospice evaluation can be difficult. Some signs that may indicate potential eligibility for hospice care are:

  • Unplanned weight loss
  • Excessive sleeping throughout the day
  • Multiple hospital visits/stays in the past six months
  • Excessive swelling of the legs and ankles, even when feet are propped up
  • Loss of appetite
  • Weakness during activities of daily living
  • Frequent changes in medications
  • Pain that is poorly controlled

  • Loss of interest in activities
  • Not “bouncing back” after an illness
  • Not responding to current treatments or therapy
  • Difficulty breathing, even at rest or with increased oxygen levels
  • Confusion
  • Wounds that aren’t healing
  • Loss of speech
  • Infections


  • When should a patient be referred to hospice?
  • Who is eligible for hospice care?
  • What is the admission procedure?
  • How long will it take to see someone?
  • Who pays for Hospice care?
  • Will I continue to take care of the patient?
  • What is the hospice team?
When the patient has six months or less to live, all attempts to cure have been stopped, and the patient/family has been told of the prognosis, then the patient should be referred to hospice. It is best not to wait until death is imminent since the team will not have time to establish rapport or intervene effectively. Sometimes the patient or family members are not all accepting of the prognosis for referral to hospice to be made.
be admitted to the hospice program, a patient must meet the criteria noted on the Eligibility Guidelines. However, the overriding guideline is a simple one: the patient must be certified as having a life expectancy of six months or less. All definitive curative therapies must be finished.
Anyone, including the patient, family member, or physician may make the initial request for service by calling (714) 367-4084. The admissions RN will record the vital information and, if necessary, contact the patient’s physician for orders and permission to admit the patient to the hospice program.
An initial visit is usually made within twenty four hours of the referral. At that time, the patient’s condition and needs are assessed. The RN will explain services, discuss how other team members will be visiting and answer any questions. This time can be the same day if the family requests.
Medicare, Medicaid and some private insurance pay for the care given by the hospice team. If a patient does not have any payment source, he/she may pay all or part of the bill, personally. The important thing to remind your patients is this: no one is denied service because of an inability to pay.
The referring physician may choose to maintain control of the care of the patient. This is the most common arrangement. If the patient is to be admitted to the inpatient unit of the hospital and the referring physician does not have admitting privileges there, the medical director will take responsibility for the inpatient care and return the patient to his doctor on discharge from the hospital.
A team made up of representatives from a variety of disciplines provides hospice care. For a detailed list, click here

Helpful Links

Accucare Cremation is the number one cremation service in San Diego county with offices in Carlsbad, San Diego and Orange County. Cadence Hospice families are given a special price when they call (800) 323-1342 and ask for the "Hospice Price" You may also download all the forms online

The National Hospice and Palliative Care Organization (NHPCO) is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States.

This organization provides information and support to patients and families facing life-threatening illnesses. With an extensive archive of articles on topics related to end-of-life care, for caregivers, family members and patients, this site is an invaluable resource.

The mission of the Administration is to develop a comprehensive, coordinated and cost-effective system of home and community-based services that helps elderly individuals maintain their health and independence in their homes and communities.

IAHPC uses different programs and resources to achieve change and improve the lives of millions of patients diagnosed with far advanced diseases around the world, especially in developing countries in Africa, Eastern Europe, Asia and Latin America.

An excellent overview of the many facets of hospice, including articles on making the hospice decision, arranging and receiving care, as well as links to other resources.

A comprehensive, innovative on-line service for hospice programs that offers staff orientation programs, annual in-services, volunteer training and specialized learning modules addressing the education needs of hospice programs of all sizes.

Everything you need to know about Medicare eligibility and benefits is here. Create an account for access to online tools to manage your Medicare coverage. Their Medicare-related caregiver resources are invaluable.