Who Makes the Hospice Decision?

Patients, families, and healthcare providers make the hospice decision together. It’s a healthcare decision. Healthcare providers use guidelines to help them decide whether a patient is eligible for Medicare-funded hospice care, which provides comfort-focused end-of-life care.

Patients can make their own choice about hospice if they are mentally competent. Usually patients get help with this choice from their family, medical providers, counselors, and spiritual advisors. Hospice team members can help, too.

Choosing a Hospice Provider

Keep these factors in mind when evaluating and choosing a hospice provider:

• Evaluate the hospice provider’s history and reputation before you decide. How long has it been in business? Does it provide all 4 levels of hospice care, as required by Medicare? What do other patients or families say about their experiences?
• Check the provider’s certification, licensing, and offerings. Is it Medicare-approved, licensed, and certified in your state? Does an entire interdisciplinary hospice team provide emotional, psychosocial, and spiritual care?
• Make sure the hospice program meets your specific needs. Does it participate in the national We Honor Veterans program? Does it provide culturally sensitive care based on your race, religion, culture, ethnicity, or lifestyle? Are staff members fluent in your preferred language?
• Explore extra services. Is someone available 24/7/365 if you have an emergency or crisis? Does the hospice team create an individualized care plan just for you? If you have severe illness, does it offer the necessary services, specialized care, and expertise to support your quality of life near the end of life?

More Help: How to Choose a Hospice Provider >

Advance Directives and Hospice Care

If patients aren’t able to make decisions or communicate, there are other options for choosing hospice care. Ideally, the patient has previously created and signed an advance directive, such as a living will. In that document, they can name another person to make medical decisions on their behalf. Depending on your state, this person is called a healthcare proxy, a healthcare surrogate, durable power of attorney for healthcare, or a healthcare agent.

If the patient does not have an advance directive, healthcare decisions are made by the next of kin: usually the spouse first, then adult children. Check your state regulations or contact your loved one’s licensed clinical social worker or case manager if you have questions.