Hospice is not only for cancer. Any terminal illness can qualify when a doctor expects a life expectancy of six months or less. Today, a large share of hospice patients have conditions such as dementia, heart disease and lung disease.
Common diagnoses in hospice
- Cancer: especially when cancer has spread and treatment is no longer working or is no longer wanted.
- Dementia, including Alzheimer’s disease: in late stages, when the person can no longer walk, speak more than a few words, or eat without help, and has frequent infections or weight loss.
- Heart disease and heart failure: when symptoms such as breathlessness or chest pain happen even at rest despite the best treatment.
- Lung disease, including COPD: when breathing is very hard even at rest and hospital visits are frequent.
- Stroke: after a major stroke, or a series of strokes, with severe loss of function and difficulty eating.
- Kidney failure: when a person chooses not to start or continue dialysis.
- Liver disease: in end-stage disease, when a transplant is not an option.
- ALS and other neurological diseases: such as Parkinson’s disease, when breathing, swallowing or movement decline significantly.
What doctors look at
For each condition, doctors use clinical guidelines to judge prognosis. Common signs across diagnoses include:
- Needing help with most daily activities
- Repeated hospital stays or infections
- Significant weight loss or declining nutrition
- Symptoms that are hard to control despite treatment
Many people have more than one serious condition. The doctor can list a primary diagnosis and related conditions that together show the person is nearing the end of life. Read more in who qualifies for hospice.
“Old age” is not a diagnosis
General decline or frailty in older age can be serious, but Medicare requires a specific diagnosis. If your loved one is declining and you are not sure why, ask the doctor to look at the underlying conditions; often one or more of them supports hospice eligibility.
Diagnosis guides
More diagnosis guides, including dementia, heart failure and kidney disease, are coming soon.
This guide is general information, not medical advice. Only a doctor can determine prognosis and hospice eligibility.