Hospice Care

Reviewed by: HU Medical Review Board | Last reviewed: January 2017.

Hospice care is compassionate care for people facing life-limiting illness or injury. It is sometimes called end-of-life care, and hospice usually involves a team approach to help the patient with medical care, pain management, emotional support and spiritual support. Hospice care can also provide counseling support to the patient’s family members. Hospice provides supportive care that aims to improve the quality of life rather than focusing on treating the illness, and the underlying belief that guides hospice care is that each person has the right to die pain-free and with dignity.1

Hospice care for lung cancer patients

Hospice may be provided to lung cancer patients and their loved ones when cancer therapies are no longer controlling the disease. Hospice care focuses on controlling pain and symptoms of lung cancer to allow patients to be as comfortable as possible near the end of life. The goal of hospice care isn’t to speed up or postpone death, and if the patient’s cancer goes into remission, hospice care can be discontinued or stopped. Making the choice to have hospice care doesn’t mean the patient is “giving up.” Rather, it means the priorities of treatment have changed.2

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Most insurance plans, Medicare and Medicaid cover hospice care with a statement from a doctor explaining that the patient has a life expectancy of 6 months or less if the cancer runs its normal course. The patient also must sign a statement to choose hospice care.2

What services does hospice include?

Hospice care may include medical professionals, medical equipment and supplies, short-term relief services for caregivers, medications to manage lung cancer-related symptoms, spiritual support and counseling, and social work services. Hospice services are provided by a team of professionals, which may include doctors, nurses, home health aides, social workers, clergy or other spiritual counselors, physical or occupational therapists, and trained volunteers. Hospice care is available to the patient and their family 7 days a week, with a team member on-call 24 hours a day. Hospice care is highly individualized to meet the needs and priorities of the patient and their family.2

Effects of hospice care on quality of life

Researchers have studied the effects of hospice on end-of-life care. In one study, patients who entered into hospice care suffered less, were physically more capable, and were better able, for a longer period, to interact with others than those who didn’t use hospice care. In addition, after the patients who used hospice died, their family members were markedly less likely to experience persistent major depression, which seems to suggest the family support provided by hospice has a lasting benefit on family members.3,4

Another study specifically looked at hospice for patients with metastatic lung cancer. Half of the 151 patients were assigned to receive traditional cancer care while the other half received traditional cancer care plus palliative care, which focuses on preventing and relieving suffering whether or not the patient is dying. Those patients who received palliative care had discussions with the palliative care specialist about their priorities for if and when their condition worsened, and they ended their chemotherapy treatment sooner, entered hospice significantly earlier, experienced less suffering at the end of their lives, and survived longer than the patients who didn’t have palliative care.3,5

How hospice relates to survival time

While many people assume that hospice care hastens death, because patients are choosing to discontinue cancer treatment like chemotherapy and are allowed higher doses of pain relievers, multiple studies have found the opposite is true. One study followed 4,493 Medicare patients who had either terminal cancer or end-stage congestive heart failure. For patients with breast cancer, prostate cancer, or colon cancer, the researchers found no difference in survival time between the patients who went into hospice care versus those who didn’t. However, for some conditions, hospice care seemed to extend survival. Patients with lung cancer gained an average of six weeks, patients with pancreatic cancer gained an average of three weeks, and patients with congestive heart failure gained approximately three months.3,6