How Long Is Someone In Hospice? Factors That Affect The Length Of Stay

Hospice care plays a crucial role in providing comfort and support for people facing terminal illness. It focuses on enhancing quality of life rather than providing curative care. The overarching goal is to ensure the person experiences comfort, dignity, and peace during their final stages of life.

One common question families and loved ones have is: How long will someone remain in hospice care? While there is no definitive answer, as each situation is unique, several factors influence the length of stay in hospice. This article will explore these factors, providing insight and clarity for those navigating this challenging journey.

Interested in learning more about hospice care, end-of-life care, and caregiving? Check if you have free access to Trualta’s learning library.

Understanding Hospice Eligibility

To understand how long someone might stay in hospice, it’s helpful to know who qualifies for this care. Hospice is a specialized healthcare service for people with terminal illnesses who are expected to live six months or less based on a doctor’s assessment.

Studies show that most care recipients remain in hospice for less than six months. For example, The National Hospice and Palliative Care Organization (NHPCO) reports that the average hospice stay for Medicare beneficiaries is about 95 days. However, many people remain in hospice care for only a few days or weeks, while 12-15% of people stay in hospice for longer than six months.

Factors That Affect The Length Of Hospice Stay

So, what determines this variability? Let’s explore the key factors.

Early vs. Late Admission

When a patient is admitted to hospice care matters—it impacts their length of stay and the quality of care they receive. Research shows that the earlier people enter hospice care, the greater the benefit. Here’s how early and late hospice admissions compare:

Early Admission

Those who enter hospice earlier benefit from more comprehensive care, including better pain management, less emotional and physical distress, and better quality of life.
Studies show that early admission to hospice can extend life expectancy while also improving comfort.

Late Admission

Some patients enter hospice just days or weeks before passing, often after stopping aggressive medical treatments.
Late admissions limit the full benefits hospice care offers, resulting in a shorter length of stay and less time to address emotional, physical, and spiritual needs.

Unfortunately, many patients and families delay starting hospice care, often due to misconceptions about hospice care and eligibility requirements. Some people think that hospice care is only appropriate in the last days of life, and others view hospice as giving up rather than an opportunity to enhance quality of life. Healthcare providers, like doctors and nurse practitioners, play a key role in ensuring patients get the most from hospice care. By discussing hospice at the appropriate time, they can help a terminally ill patient, their family, and their caregiver access the support they need when they need it most.

The Nature & Progression Of The Illness

The type of illness and its progression are among the most significant factors influencing the length of stay in hospice.

Cancer

Patients with terminal cancer often have a more predictable disease trajectory.
Physicians can better estimate the progression and timing of decline based on tumor growth, treatment history, and symptom patterns.
Hospice stays for cancer patients may align more closely with the six-month or less estimate.
Research indicates that people with cancer typically have the shortest length of stay.

Non-Cancer Diagnoses

Conditions such as heart failure, chronic obstructive pulmonary disease, dementia, or other neurological conditions have less predictable trajectories.
These illnesses often involve periods of decline followed by stabilization, making it harder to determine the end stage.
NHPCO reports that patients with these conditions typically have a longer length of stay in hospice.

Age Of The Care Recipient

Age influences the length of stay in hospice care. Studies indicate that older patients often have shorter hospice stays compared to younger people. This trend may result from older adults enrolling in hospice later in their illness progression, possibly due to delayed referrals or personal preferences. On the other hand, younger patients might seek hospice services earlier, leading to longer periods of care. Families and caregivers should be aware of this trend to avoid waiting too long before seeking hospice services, ensuring their loved ones benefit fully from end-of-life care.

An older adult woman lies in bed under the covers. She wears glasses, and her eyes are closed. A person whose face isn’t visible leans over to look at her.

Location Of Care

Hospice care can take place in different settings, depending on the patient’s needs and preferences. Where a patient receives hospice care can influence their length of stay. Data shows noticeable differences depending on the care setting, which can often reflect the level of support and resources available.

Private residence: Patients receiving hospice care at a home tend to have shorter stays. Patients at home often enter hospice later in their illness, possibly due to delays in deciding to transition from curative treatments to hospice care.
Nursing homes: In nursing facilities, the average length of stay increases. Nursing home residents who receive hospice care already receive some structured medical oversight, resulting in moderate stay lengths.
Assisted living facilities: Patients in assisted living facilities generally have the longest stays. Assisted living residents, who already receive ongoing care, are often referred earlier, allowing for longer hospice stays.

The location of care can shape not only the length of hospice stay but also the overall experience, as it impacts how quickly patients are identified as eligible for hospice and how much support they receive throughout their illness.

The Patient’s Response To Hospice Care

Studies have shown that patients with illnesses like advanced heart failure, cancer, or chronic obstructive pulmonary disease (COPD) sometimes live longer in hospice care compared to those who don’t receive hospice care. For example, a study published in the Journal of Pain and Symptom Management found that hospice patients with these terminal illnesses lived an average of 29 days longer than those who did not receive hospice care.

In summary, these studies show how prioritizing comfort and dignity through hospice can not only enhance quality of life but, for some patients, also lead to unexpected extensions of life. This highlights the value of hospice care as a supportive and compassionate approach to end-of-life care.

Reevaluation & Recertification

The hospice team, including the hospice physician and the hospice nurse, regularly reevaluate a patient’s eligibility for continued care. If a patient’s condition stabilizes or improves, they may be discharged from hospice. However, if they continue to decline after hospice discharge, they can be readmitted to hospice care when appropriate.

These ongoing evaluations by the hospice provider ensure that patients remain eligible for the hospice program, even if they outlive the initial six-month prognosis.

Conclusion: Every Journey Is Unique

The length of time someone remains in hospice care varies greatly depending on their terminal illness, timing of admission, age, location of care, individual response to care, and reevaluation. While the six-month prognosis serves as a guideline, many patients stay in hospice for shorter or longer periods.

What matters most is that hospice provides compassionate, dignified care tailored to the patient’s needs. Whether for days, weeks, or months, hospice care ensures a hospice patient and their families find comfort and support during life’s most challenging moments.

If you or a loved one are considering hospice care, reaching out to a local provider can offer clarity and help you make informed decisions. Remember, hospice is not about giving up, it’s about making the most of every moment.

Interested in learning more about hospice care, end-of-life care, and caregiving? Check if you have free access to Trualta’s learning library.

References:

How Long Is Someone In Hospice? Factors That Affect The Length Of Stay

Understanding Hospice Eligibility